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Watching four or more hours of television has shown to cause an increased risk of cardiovascular disease mortality of 80 percent. METRO photo
Expanded viewing habits have effects on your physical and mental health

By David Dunaief, M.D.

Dr. David Dunaief

Comcast, one of America’s largest cable and internet providers, reported in May that Americans were watching an additional 8-plus hours of programming a week, whether on a television, computer or a portable device since the pandemic’s beginning (1). For our purposes, we’ll call this TV, because most is consumed while sitting, although the average watching modality has shifted considerably.

What impact does all this watching have on our lives? It may be hazardous to your health. I know this seems obvious, but bear with me. The extent of the effect is surprising. According to 2013 Netflix research, binge-watching, or watching more two or more episodes of a single program in a row, is perceived as providing a refuge from our busy lives.

This also has an addictive effect, prompting dopamine surges as we watch. Interestingly, it also can lead to post-binge depression when a show ends and to isolation and lower social interaction while viewing (2). Of course, while socially isolating, binge watching can help kill hours, but the negative effects are still relevant.

TV’s detrimental effect extends beyond the psychological, potentially increasing the risk of heart attacks, diabetes, depression, obesity and even decreasing or stunting longevity. My mother was right when she discouraged us from watching television, but I don’t think even she knew the extent of its impact.

Cardiovascular events including heart attacks

There was a very interesting observational study published in the New England Journal of Medicine that showed watching sporting events increases the risk of heart attacks and other cardiovascular events, such as arrhythmia (irregular heartbeat) and unstable angina (severe chest pain ultimately due to lack of oxygen). The researchers followed Germans who watched the FIFA (soccer) World Cup playoffs in 1996.

How much did watching increase the risk of cardiovascular events? This depended on what round of the playoffs and how close a game it was. The later the round and the closer the game, the greater the risk of cardiovascular events. Knockout games, which were single elimination, seemed to have the greatest impact on cardiovascular risk.

When Germany was knocked out in the semi-finals, the finals between France and Italy did not have any cardiovascular effect.

Overall, men experienced a greater than three-fold increase in risk, while women experienced an increased risk that was slightly below two-fold. According to the authors, it was not the outcome of the game that mattered most, but the intensity. The study population involved 4,279 German residents in and around the Munich area (3).

Another study found that, compared to fewer than two hours a day, those who watched four or more hours experienced an increased risk of cardiovascular disease mortality of 80 percent. I know this sounds like a lot of TV, but the average daily American viewing time is significantly over this. This study, called the Australian Diabetes, Obesity, and Lifestyle study (AusDiab) was observational looking at 8800 adults over a six-year period (4).

Impact on Life Expectancy

The adage that life tends to pass you by when you watch TV has a literal component. An observational study found that TV may reduce the life expectancy of viewers. In the study, those who watched at least six hours per day during their lifetime had a decrease in longevity of 4.8 years. However, this is not the whole story. What is even more telling is that after the age of 25, for every hour of TV, one might expect to potentially lose 21.8 minutes of life expectancy (5). According to the authors, these results rival those for obesity and sedentary lifestyles.

Diabetes and Obesity Risk

In the Nurses’ Health Study, for every two hours of television viewing on a daily basis there were increased risks of type 2 diabetes and obesity of 23 percent and 14 percent, respectively (6). The results show that sitting at work for two hours at time increased the risk of diabetes and obesity by only five percent and seven percent respectively, much less of an effect than TV-watching. The authors surmise that we can reduce the incidence of diabetes and obesity by 43 percent and 30 percent by cutting our TV time by 10 hours a week.

Modestly reducing the amount of television is a simple lifestyle modification that can have a tremendous impact on longevity, quality of life and prevention of the top chronic disease. So, step away from your television, tablet or computer and take a walk outside, do some calisthenics, or even take up a new hobby that doesn’t involve sitting on the couch. Your body and your psyche will thank you.

References:

(1) corporate.comcast.com (2) nbcnews.com/better/health/what-happens-your-brain-when-you-binge-watch-tv-series-ncna816991. (3) N Engl J Med 2008; 358:475-483. (4) Circulation. 2010 Jan 26;121(3):384-91. (5) Br J Sports Med doi:10.1136/bjsm.2011.085662. (6) JAMA. 2003 Apr 9;289(14):1785-91.

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

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METRO photo

By Elof Axel Carlson

Elof Axel Carlson

Science is a way of enlarging our knowledge about the  universe. It is not the only way to do so.  We can experience the universe through our travels, our observation of the changing seasons, our feelings of awe at a glorious sunset, or the joy of seeing a rainbow form after a passing rain shower. 

We can also experience a feeling that many call spiritual, through meditation, prayers, or reverential feelings. All societies experience these different ways of encountering the diversity of the universe and how to classify the world we experience around us. What sets science apart is its use of reason and tools to explore the universe.

Experimental science was formalized during the renaissance especially in Italy where Galileo and his students did experiments to work out the first laws of physics using inclined planes and quantitative relations to show a mathematical measure of speed and acceleration. Galileo also added the use of the telescope to explore the heavenly bodies and showed Venus had phases like the moon, the moon had craters and mountain ranges, Jupiter had 4 moons whose orbits he and his students worked out, and the sun had sunspots whose migrations allowed him to show the sun rotates on an axis.

That is not knowledge one gets from revelation or looking for bible codes in the Old Testament verses. It led to a dualism with Descartes and other philosophers seeing the universe as containing two realms – the material universe accessible to science through reason and experimentation and the spiritual or supernatural world that was accessible by revelation and scriptural interpretations of theologians. The Renaissance was also contentious, and Protestants and Catholics fought over who should interpret the Bible.

The relation between the world interpreted by science and the world interpreted by the supernatural has been an uneasy one ever since the Renaissance. Many people have no problem balancing the two ways to experience their lives. Other feel uncomfortable with the supernatural or uncomfortable with the scientific outlook expressed as atheism agnosticism, humanism, or scientism.

I am a scientist, and in that role I avoid explanations invoking the supernatural. I describe what is accessible through observation, experimentation, and the tools of science to investigate what is complex and render it interpretable through my studies. But I am also a human being who enjoys listening to music, going to museums to see great artworks and reading wonderful books of fiction and human imagination.

Science enlarged the universe I can live in and made possible the long life I have lived.  Some people, however, have a more ambivalent relation to science. They see it as destructive to their spiritual beliefs. They see it as destroyer of their children’s faith. They see it as sterile of emotions and human feelings. They see it as a rival that deprives them of the total freedom of the will to do what they want when they want. 

We see this in the  responses to the  advice offered by the nation’s epidemiologists and microbiologists who have studied infectious disease. Germs have no ideology. They have hosts. Those hosts can include you or me.

My response to a contagious disease is to follow what science recommends. I get a flu shot each year. I was immunized in my youth against smallpox, polio, and whooping cough. I had the measles and got an autoimmunity from that as was the case for mumps during the Depression years I grew up.

I am puzzled that adults can take offense at being told to  wear a facial mask to prevent spraying their germs in the streets and rooms they occupy as well as serving as a protection from those germs exhaled from our mouths and noses.

I am puzzled that people belittle scientists who measure the oceans’ temperatures and the study of the melting of glaciers around the polar regions and who keep careful records showing increases of carbon dioxide in the atmosphere and a rising temperature of the atmosphere and a rising sea level and more numerous and severe climate changes around the world. The evidence is overwhelming that it is caused by a fossil fuel carbon-based civilization and that it needs regulation through international treaties.

But those who ignore or reject science do not offer an alternative to changing our habits of how we live. What is it besides “wishful thinking” or denial that they offer in response? I am not advocating that science always has good outcomes. Science, like all human activity, has to be monitored, assessed and regulated. Pollution of the land, air and waters that are essential  for our lives needs regulation. Science often lends its help to the construction of weapons of mass destruction which is just rationalized murder of the innocent who are embedded in the guilty we designate as the enemy.

In a democracy it is our obligation to debate the uses and abuses of science as well as the uses and abuses of cultural beliefs and political ideologies. It is false to believe that society and nature are always self-correcting without human involvement in how we respond to the  threats often of our own making.

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

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File photo

When Suffolk County Executive Steve Bellone (D) announced the 30-member police reform task force last Wednesday, Sept. 9, there was not much in the way of fanfare for what should be a big moment for the general police reform movement.

Like the sound of a flat trumpet announcing the arrival of the king, it did not create any kinds of sensation other than pursed lips and a general groan from the community at large.

The news has left people on both entrenched sides of the police debate uncomfortable. One side probably thinks it is a dangerous waste of time, the other believes it to be an attempt at lip service, one piloted by the same people advocates accused of sustaining bad practices within departments.

The muted and sometimes hostile response to the new task force is likely due to how long it took the county to actually release its own plans. It has been over three months since Gov. Andrew Cuomo (D) released his first executive order mandating that the government actually looks into this. Police reform advocates have hounded his heels since then but the county exec stood mum. Perhaps he, like others, was confused by what the county should have been doing to prepare for what is likely seen as another unfunded mandate from New York State.

But this is bigger than that, or at least, it should be. Bellone and other police officials should have been upfront about what they were going to do and how they would do it. At least then they wouldn’t have been in a “damned if you do, damned if you don’t” situation as they are now. Especially because without a plan, Cuomo has promised municipalities’ police departments could lose state funding.

Suffolk County police officials throughout the entirety of the police debate have touted recent advancements in anti-bias training and department reform that was happening even before Minneapolis man George Floyd was killed at the hands of police.

And to say there haven’t been significant efforts would be a disservice to the several notable people within the police department who have strived to increase inclusivity and enact change for the better. Most times, however, it’s better to let the people themselves tell you if that change has been enough, rather than just sitting in the echo chamber that is bureaucracy.

The 30-person task force is effectively evenly split between Suffolk County officials/police reps and other religious, racial and community groups. This disparate set of characters plans to hold eight meetings, one for each precinct plus the East End, then using another large survey the county has announced alongside the task force, craft some sort of policy plan.

The Suffolk County Police Benevolent Association will of course advocate for no changes to police budgets or personnel. Their leadership has been staunch supporters of Blue Lives Matter rallies and have routinely decried any and all Black Lives Matter protests, even though in the county the vast majority have been peaceful and civil. That’s not to say police don’t have the right to speak up for themselves. We know just how much work goes into serving a community as an officer — from the holidays not spent with families to the danger they put themselves in every day. But we need to listen to communities, especially the large communities of color, for whether they feel police actually treat them the way many of us on the North Shore feel we are positively reflected.

We at TBR News Media think there should be a minority report, or potentially multiple minority reports, to go along with whatever result gets crafted before the governor’s April 2021 deadline. That way we can see what was left on the cutting room floor and, more importantly, how either police reps or reform advocates feel things should be done if they had their way.

It’s time to stop thinking of this task force as an afterthought and move toward some consensus that leads to real change.

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By Matthew Kearns, DVM

When a client brings their pet into my office and states that they are drinking more and urinating in the house a few common diseases come to mind. One prominently on the list is Cushing’s disease. Cushing’s disease is caused by hyperadrenocorticism, or an overactive adrenal gland. The adrenal glands are two small glands that sit in front of the kidneys and are responsible for homeostasis. Homeostasis, as described to me back in veterinary school, is “keeping our bodies even in an uneven world.”

The adrenal glands produce hormones that regulate blood pressure, control electrolyte balance, produce precursors to the sex hormones (estrogen, testosterone), and control metabolism and immune function. The portion of the adrenal gland that causes Cushing’s disease is called the zona fasciculata. This portion of the gland is responsible for producing cortisol, or the body’s natural cortisone.

Cushing’s disease is most often found in Poodles, Boston Terriers, Pomeranians, Maltese, Beagles, Dachshunds, and Cocker Spaniels.

Normal concentration of cortisol is imperative in the metabolism of carbohydrates, proteins and fats. Cortisol also plays a crucial role in the immune system by acting as a natural anti-inflammatory. The overproduction of cortisol leads to the symptoms associated with Cushing’s disease. These symptoms include increased thirst and urination, increased appetite, hair loss along the back, abdominal distension, muscle weakness, increased risk of common infections associated with suppression of the immune system such as skin, or urinary tract infections.

Cushing’s disease is much more common in dogs than cats. Any dog can develop Cushing’s disease but breeds more at risk are Poodles, Boston Terriers, Pomeranians, Maltese, Beagles, Dachshunds, and Cocker Spaniels to name a few.

Diagnosis of Cushing’s disease is made with bloodwork. Screening tests will usually reveal an increase in certain liver enzymes. There may be other changes but the hallmark is an elevation in liver enzymes. The definitive diagnosis is made with what is termed an “adrenal stress test.” Basically, a baseline sample of blood is taken, followed by medication to stress the adrenal glands. Additional samples are taken to measure how the adrenal glands respond. Additional testing such as ultrasound or MRI are recommended but not required for diagnosis.

Once a diagnosis of Cushing’s disease is made medication is dispensed. Older medications such as mitotane or ketoconazole are still used but have more side effects. A newer medication called trilostane is much safer. Follow up bloodwork is used to monitor treatment and either adjust dosages, or consider other medications.

If your pet (especially your dog) is drinking more and urinating more bring them to your veterinarian right away. Cushing’s may be the cause and early diagnosis and intervention is always most successful.

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. Have a question for the vet? Email it to [email protected] and see his answer in an upcoming column.

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From Photofest

By Daniel Dunaief

Daniel Dunaief

Normally, I’d build towards my request, but I know you’re busy. So, here’s the request: please send stories about your observations of graceful actions in our community. When I get enough of them, I’ll put them together in an article. If they keep coming, I’ll put together additional columns.

Now, onto the pitch: the challenges of today and in the uncertain times ahead continue to increase even as we are now only a few months away from the countdown to 2021. What kind of Halloween will we have this year? What kind of Thanksgiving, Christmas, Hanukkah, Kwanzaa or, if you’re a fan of the show Seinfeld, Festivus, awaits? We know we can’t plan for the kinds of things that we used to, like seeing friends and family in large groups, snuggling up close to watch movies or to tell stories of the triumphs of our children or our companies.

As of the date of this week’s paper, we have 47 days between now and the election and who knows how much longer between now and when an already-contested national election is actually decided. That means we will hear the word “disgraceful” bandied about as if it were the best way to take down the other side.

Democrats and Republicans will call the acts, thoughts and plans of the other side “disgraceful.” While you may agree with one person or party about how your favorite politician’s opponent is, indeed, completely lacking in grace and has ideas, thoughts or expressions that are as close to an abomination as you can imagine, those words and accusations don’t elevate your hero or you, for that matter.

Sure, it feels good to find targets for the frustrations and disappointments of a difficult year. However, during challenging times such as these, how about if we share the grace with which people are handling these challenges?

Teachers, principals, janitors and everyone else associated with schools are operating under extremely difficult conditions. Surely you must have seen one of the people in the education world come up with a graceful solution to these maddening moments?

Then there are all the people involved in health care, from first responders, to nurses, to doctors. I suspect we could create a wall of stories that reveal the grace under pressure that not only inspired you over the course of this difficult year, but also could inspire other readers looking for positive messages.

Police officers, fire fighters and other emergency services workers never know exactly what they’ll face in a day, from a cat stuck in a tree to an unstable domestic violence incident, to an escalating confrontation among protesters on opposite sides of a boiling nation. The grace some of these people demonstrate can lower the temperature and restore calm and peace.

Speaking of grace, religious leaders can and do lead by example, writing sermons and acting with patience and dignity that encourage us to find the best of ourselves.

While it’s tempting to write that Mrs. Smith is a graceful teacher, please think about what she does that’s so endearing. When you show us the story, by providing an anecdote about how Mrs. Smith defused a bullying situation or encouraged your daughter to stop sucking her thumb with subtle hand gestures, you are taking our hand and leading us into that socially-distanced classroom full of masked learners.

Hopefully, whatever stories you share, if you have the time, will motivate us to follow the examples of others who have found a way, despite circumstances that may seem out of their control, to reveal the kind of grace that soothes the soul and brings meaning to each day.

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By Leah S. Dunaief

Leah Dunaief

Somehow reading about other troubled times makes for good escapism at this weird COVID-19 period of our existence. I just finished a wonderful, non-fiction, carefully researched book by Diana Preston, “Eight Days at Yalta,” and I recommend it for your next page turner.

Even though we all know how WWII came out and how the leaders of the Allies met at Yalta in Crimea to work out the details of the war’s conclusion and the post-war map, the story is still fascinating. The characterizations of Stalin, Churchill and Roosevelt, their interactions, their motivations and their deceptions make for riveting reading. And incidentally, those decisions still affect us today.

Originally scheduled for the end of 1944, the meeting was postponed until February 4-11 of the following year at Roosevelt’s request. He wanted it to happen after he was inaugurated in January for his unprecedented fourth term. Despite his obvious illness, he agreed to travel thousands of miles in the middle of winter, and he got there via train, ship, plane and limo. He was the youngest of the three leaders, at 63, and would die barely two months later. His fragile condition was noted by many of the participants, and he was accompanied by his only daughter, Anna Boettiger, who tried valiantly to protect her father’s health and help him conserve his energies.

Churchill insisted on first meeting Roosevelt at Malta, where the President’s ship, the USS Quincy, delivered him and his entourage to Europe. Though just 17 miles long and nine miles wide, Malta served as a strategic position in the British supply line. As a result, it was subject to constant air raids day and night by German and Italian pilots. Twice the amount of bombs fell on the rocky island as fell on London during the Blitz. No business was discussed there because Roosevelt did not want to give the impression that the two were ganging up on Stalin.

Churchill, 70 and the oldest, was also accompanied by his daughter, Sarah. The two English-speaking leaders, surrounded by heavy security from both countries, then flew on to Saki, in the Crimea, in separate planes. From there, they set out for the milder climate of Yalta in cars, some 90 miles away. The road was so filled with potholes from bombings that one of the Admirals traveling with Roosevelt complained the ride, which lasted for five hours, “was breaking every bone in his body.”

Stalin, 65, made the 1000 mile trip by rail from Moscow. He disliked flying because his only experience had been a white-knuckled flight across the Caspian Sea to the Tehran Conference, the big three’s previous rendezvous. Both he and Churchill were short and stout, with Roosevelt measuring over six feet when standing. Foreign diplomats were surprised by the dictator’s seeming charm, the softness of his voice and how, unlike others, especially Churchill, he often seemed prepared to listen to what they had to say rather than to speak himself. They concluded the conference liking him. Of the three, he was probably the healthiest.

Roosevelt had two main goals that he wished to obtain from the meeting. He was determined to set the architecture for a lasting peace through the creation of a United Nations. And he desperately wanted the Russian military to join in the fighting against Japan when the war in Europe was won, which happened in April.

The American casualties at Iwo Jima were huge and foreshadowed the terrible cost in lives of an attack on the Japanese homelands. He achieved both but at a loss of Eastern European countries to the Soviet Union. And as it turned out, the United States did not need Russian help in defeating Japan, although as time went on, Stalin hastened to join the fighting, so as to share in the post-war spoils. The President clearly did not understand the coming power of the atomic bomb, which was dropped on Hiroshima only six months later.

There are, according to the author, disconcerting similarities between Stalin and Putin.

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Mia
Mia

MEET MIA!

This week’s shelter pet is Mia, a 2-year-old brindled beauty currently waiting at the Smithtown Animal Shelter for her knight in shining armor.

Mia is a lab/pit mix with a goofball spirit and a loving personality. Left to grow up as a yard dog, she did not receive the love and attention she deserved as a puppy and needs an experienced home where she can learn what it is to be a normal dog with a loving family. She is as playful and affectionate as they come and believes herself to be a 70 pound lap dog!

Mia is spayed, microchipped and up to date on all her vaccines.

If you are interested in meeting Mia, please call ahead to schedule an hour to properly interact with her in the shelter’s Meet and Greet Room. The Smithtown Animal & Adoption Shelter is located at 410 Middle Country Road, Smithtown. For more information, please call 631-360-7575 or visit www.smithtownanimalshelter.com.

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By Barbara Beltrami

I think if my husband and I had a family crest it would be the tomato! They are as necessary a staple as flour, sugar, or salt; as indispensable as onions, carrots or celery for the foundation of so many recipes and menus.

In the winter we have to rely on canned San Marzano tomatoes and fresh camparis, but come May we stick a variety of plants in patio pots and lovingly fertilize, water and stake them. By August we are happily picking a few a day but they’re not nearly enough to satisfy our tomato appetites nor do many even make it to the table because we eat them while they’re still warm from the sun. So we supplement our modest little crop with field tomatoes from the farm stand.

Although we sometimes chop them into a fresh tomato sauce for pasta or sauté them with other summer vegetables, most often we just slice them, top them with fresh basil or parsley or scallions, coarse salt and freshly ground pepper, drizzle them with olive oil and enjoy their exquisite flavor. Or sometimes, we take just one of our nice ripe tomatoes, cut it in half and rub it on toasted slices of rustic bread with a little shot of extra virgin olive oil for good measure.

Cherry Tomato Tart

YIELD: Makes 6 to 8 servings

INGREDIENTS:

One 9-inch pastry crust

3 pounds cherry tomatoes, halved

1/4 cup extra virgin olive oil

1 tablespoon fresh thyme leaves

1/4cup chopped fresh basil leaves

Salt and freshly ground pepper to taste

2 garlic cloves, bruised and chopped

2 tablespoons sour cream

1 tablespoon grainy mustard

1/2 cup extra sharp Cheddar cheese, grated

DIRECTIONS:

Preheat oven to 350 F. Line bottom and sides of tart pan with pastry crust; cut to make even with top edge; gently pat a piece of foil on top of crust and spread pie weights over it. Meanwhile in a large bowl, toss the tomatoes with the olive oil, thyme, basil, and salt and pepper and garlic. Spread the mixture with the tomatoes, cut side down on a baking sheet and roast until tomatoes blister and dry up a little, about 20 to 30 minutes.

Remove from oven, set tomatoes on paper towels and blot to remove excess liquid. Bake pie shell in preheated oven until set, about 30 to 35 minutes; remove pie weights and foil and bake another 5 to 10 minutes until golden. In small bowl, mix the sour cream and mustard, then spread on pie crust; sprinkle with cheese. Arrange tomatoes, cut side up, in two layers; add salt and pepper between layers. Bake until tomatoes just start to brown, about 20 to 25 minutes. Serve hot, warm or at room temperature with a green salad.

Pasta with Fresh Tomatoes

YIELD: Makes 4 to 6 servings

INGREDIENTS:

1 pound penne or similar size pasta

1/4 cup extra virgin olive oil

1 garlic clove, minced

1/2 teaspoon crushed red pepper flakes

6 to 8 fresh Roma tomatoes diced

1/3 cup chopped fresh basil leaves

Salt to taste

DIRECTIONS:

Cook pasta according to package directions. Meanwhile in medium-large skillet warm oil over medium heat; add garlic and pepper flakes; cook, stirring constantly, until garlic releases its aroma, about 30 seconds; add tomatoes, stirring frequently, and cook until barely softened, about one minute. In large bowl toss tomatoes with basil, hot pasta and salt. Serve hot or let cool to room temperature and serve with an arugula salad.

Greek Tomato Salad

YIELD: Makes 4 to 6 servings

INGREDIENTS:

3 to 4 pounds ripe beefsteak tomatoes

1 small red onion, peeled and sliced into thin rings

1 green bell pepper, peeled, seeded, julienned

1 medium cucumber, peeled, seeded, diced

Sea salt and freshly ground pepper to taste

6 ounces feta cheese, broken into chunks

3 tablespoons chopped fresh dill

Extra virgin olive oil, to taste

DIRECTIONS:

Wash, core and slice tomatoes 1/4” thick and arrange on a platter. Scatter onion, pepper and cucumber over tomatoes and sprinkle with salt and pepper; let sit 15 minutes; scatter feta cheese and dill and douse with olive oil.  Serve at room temperature with toasted pita and hummus.

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By Lisa Scott

Every state has its own election laws. New York State’s laws have been more restrictive than many others, although progress has been made in the past few years. In-person early voting commenced in 2019 and absentee ballot eligibility expanded in 2020 to anyone who has concerns due to COVID-19. We now have electronic (iPad-style) poll books and during early voting customized ballots for each voter are printed.

Your vote will count in November if you educate yourself, develop a voting plan with others if possible, and plan ahead. Waiting until the last minute, particularly with an absentee ballot, increases the odds of your missing deadlines or making a paperwork mistake with no time for correction.

Fortunately, in New York State you have several options for casting your ballot: Absentee Ballots, Early Voting, and Election Day Voting. Follow the steps below, and call the Suffolk County Board of Elections (SCBOE) at 631-852-4500 or, if you have a simple question, call the League of Women Voters (LWV) at 631-862-6860. The LWV is non-partisan, not affiliated with the Board of Elections and cannot give you election advice.

Governor Andrew Cuomo has ordered all Boards of Elections in NYS to mail a letter to all households with registered voters in early September. The letter will give polling place information, details for early voting, and an explanation of the absentee ballot process for the November elections.

Voter Registration

You must be registered in order to vote. You may register if you will be 18 years of age by Election Day, a resident of the county for at least 30 days prior to the election, and a citizen of the United States. 16 and 17 year-olds can now pre-register to vote, but will not be able to vote until they are 18. You may only vote in one state. If you have moved within the state since the last time you voted, you will be able to vote via affidavit ballot in your new election district, but re-registering with your new address before Oct. 9 is advisable.

Registration forms are available at the Board of Elections, post offices and libraries. Online voter registration is possible via the DMV website if you are already in their website. You can call 1-800-FOR-VOTE hotline to request a voter application. You can download and print a form from the New York State Board of Elections (NYSBOE) homepage link Need a Voter Registration Form. The deadline to register is Oct. 9. (If mailed your registration form must be postmarked by that date.) The registration form includes a place where you can also immediately request an absentee ballot.

Absentee Ballot Voting

Unlike June primary voting: Absentee ballot applications will not automatically be sent to everyone – you must apply for one! The deadline to apply is October 27 – DO NOT WAIT – You may apply NOW.

The fastest, simplest, method is online! NYSBOE has introduced an online form at absenteeballot.elections.ny.gov. You only need to enter your county, name, date of birth and zip code. Within seconds you will receive a printable absentee ballot confirmation and number.

You may also email, fax or telephone your request for an absentee ballot to the SCBOE. Details are at https://suffolkcountyny.gov/Departments/BOE/Absentee-Voting-FAQ.  When you receive your ballot follow all instructions.

Fill it out, sign and enclose the oath envelope, apply postage and mail as soon as you can. You may also (in person, or via a friend or relative) bring the SEALED ballot to the SCBOE in Yaphank or to any  Suffolk early voting site during open hours, or to your polling place on November 3.

The BOE must now send a letter to the voter within 24 hours of receipt of an absentee ballot with a problem (e.g. no signature). You should send your ballot in early so that, the BOE would have time to alert you of a problem and you would be able to correct the issue before deadlines.

The Board of Elections will start mailing out absentee ballots Sept. 18. This cannot be done until the candidate list is certified. After you’ve submitted your absentee ballot, you can call the SCBOE to confirm your ballot was received. If you had requested an absentee ballot due to COVID-19 in June, you still MUST reapply for November 2020. NYS absentee ballot application rules for 2021 have not yet been determined.

In New York State, unlike most other states, you can still vote in person even if you voted on an absentee ballot. The absentee ballot will be discarded by the BOE if you’ve already voted in person. Absentee ballots will be counted beginning 48 hours after Election Day. Absentee ballot voter names will be checked against the electronic poll book before being processed.

Early Voting

There are 12 Early Voting sites in Suffolk County. Registered Suffolk County voters may vote at ANY of the 12 sites during the Early Voting period. This is possible because of the new electronic poll books, and ballots that are printed on demand for each voter. All NYS counties have the same 9 early voting dates (Sat. Oct. 24  to Sun. Nov. 1), but times each day vary. No one can vote in person on Nov. 2.

To vote on Election Day in person

Polls are open on Nov. 3 from 6 a.m. to 9 p.m. in Suffolk County. Look up your voter registration and polling place online to reconfirm all is in order. You can do that via the NYSBOE homepage link Find Out if you are Registered and Where to Vote.

The best on-line sources of information are VOTE411.org (select your state and you can register to vote, find your polling place, see what’s on your ballot and learn about the candidates) and the New York State Board of Elections at elections.ny.gov.

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

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White fleshy fruits like apples, pears and bananas have shown to decrease ischemic stroke risk. Stock photo
Medications and lifestyle play important roles

By David Dunaief

Dr. David Dunaief

Stroke remains one of the top five causes of mortality and morbidity in the United States (1). While some risk factors are out of our control, like family history and age, many of our risks can be altered by making lifestyle changes and managing contributing diseases, like hypertension and diabetes.

We have a wealth of studies that inform us on the roles of medications and lifestyle in managing risk. Of particular importance are medication guidelines that balance the risks and benefits of different stroke prevention regimens.

Medications can be protective

Two medications have shown positive impacts on reducing stroke risk: statins and valsartan. Statins are used to lower cholesterol and inflammation, and valsartan is used to treat high blood pressure. Statins do have side effects, such as increased risks of diabetes, cognitive impairment and myopathy (muscle pain). However, used in the right setting, statins are very effective. Some studies have shown reduced mortality from stroke in patients who were on statins at the time of the event (2). Patients who were on a statin to treat high cholesterol had an almost six-fold reduction in mortality, compared to those with high cholesterol who were not on therapy.

There was also significant mortality reduction in those on a statin without high cholesterol, but with diabetes or heart disease. The authors surmise that this result might be from an anti-inflammatory effect of the statins. Of course, if you have side effects, you should contact your physician immediately.

Valsartan is an angiotensin II receptor blocker that works on the kidney to reduce blood pressure. However, in the post-hoc analysis (looking back at a completed trial) of the Kyoto Heart Study data, valsartan used as an add-on to other blood pressure medications showed a significant reduction, 41 percent, in the risk of stroke and other cardiovascular events for patients who have coronary artery disease (3).

It is important to recognize that high blood pressure and high cholesterol are two of the most significant risk factors for stroke. Fortunately, statins can reduce cholesterol, and valsartan may be a valuable add-on to prevent stroke in those patients with coronary artery disease.

Use caution with medication combinations

There are two anti-platelet medications that are sometimes given together in the hopes of reducing stroke recurrence — aspirin and Plavix (clopidogrel). The assumption is that these medications together will work better than either alone. However, in a randomized controlled trial, the gold standard of studies, this combination not only didn’t demonstrate efficacy improvement but significantly increased the risk of major bleed and death (4, 5).

Major bleeding risk was 2.1 percent with the combination versus 1.1 percent with aspirin alone, an almost twofold increase. In addition, there was a 50 percent increased risk of all-cause death with the combination, compared to aspirin alone. Patients were given 325 mg of aspirin and either a placebo or 75 mg of Plavix. The study was halted due to these deleterious effects. The American Heart Association recommends monotherapy for the prevention of recurrent stroke. If you are on this combination of drugs, please consult your physician.

Managing aspirin dosing

Greater hemorrhagic (bleed) risk is also a concern with daily aspirin regimens greater than 81 mg, which is the equivalent of a single baby aspirin. Aspirin’s effects are cumulative; therefore, a lower dose is better over the long term. Even 100 mg taken every other day was shown to be effective in trials. There are about 50 million patients who take aspirin chronically in the United States. If these patients all took 325 mg of aspirin per day, an adult dose, it would result in 900,000 major bleeding events per year (6). Do not take an aspirin regimen — even a low-dose aspirin regimen — for stroke prevention without consulting your physician.

Protection from fruits and vegetables

A prospective study of 20,000 participants showed that consuming white fleshy fruits — apples, pears, bananas, etc. — and vegetables — cauliflower, mushrooms, etc. — decreased ischemic stroke risk by 52 percent (7). Additionally, the Nurses’ Health Study showed that foods with flavanones, found mainly in citrus fruits, decreased the risk of ischemic stroke by 19 percent (8). The authors suggest that the reasons for the reduction may have to do with the ability of flavanones to reduce inflammation and/or improve blood vessel function. I mention both of these trials together because of the importance of fruits in prevention of ischemic (clot-based) stroke.

Fiber’s role

Fiber also plays a key role in reducing the risk of a hemorrhagic stroke. In a study involving over 78,000 women, those who consumed the most fiber had a total stroke risk reduction of 34 percent and a 49 percent risk reduction in hemorrhagic stroke. The type of fiber used in this study was cereal fiber, or fiber from whole grains.

Refined grains, however, increased the risk of hemorrhagic stroke twofold (9). When eating grains, it is important to have whole grains. Read labels carefully, since some products that claim to have whole grains contain unbleached or bleached wheat flour, which is refined.

Fortunately, there are many options to help reduce the risk or the recurrence of a stroke. Ideally, the best option would involve lifestyle modifications. Some patients may need to take statins, even with lifestyle modifications. However, statins’ side effect profile is dose-related. Therefore, if you need to take a statin, lifestyle changes may help lower your dose and avoid harsh side effects. Once you have had a stroke, it is likely that you will remain on at least one medication — typically low-dose aspirin — since the risk of a second stroke is high.

References:

(1) cdc.gov. (2) AAN conference: April 2012. (3) Am J Cardiol 2012; 109(9):1308-1314. (4) ISC 2012; Abstract LB 9-4504; (5) www.clinicaltrials.gov NCT00059306. (6) JAMA 2007;297:2018-2024. (7) Stroke. 2011; 42: 3190-3195. (8) J. Nutr. 2011;141(8):1552-1558. (9) Am J Epidemiol. 2005 Jan 15;161(2):161-169.

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

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