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Pinot Grigio grapes come in a range of skin colors. METRO photo

By Bob Lipinski

Bob Lipinski

Pinot Grigio is the number one selling white wine from Italy and has been for many years. This fruity, easy-to-drink, dry to off-dry wine is made throughout the world with the bulk coming from Northern Italy.

The popular wine has been grown in Italy since the beginning of the nineteenth century, when it was first introduced in Piedmont. Cultivation of the grape moved eastwards over the decades and now finds its home in the Tre Venezie, a term used to describe the three contiguous northeastern regions of Friuli-Venezia Giulia, Veneto, and Trentino-Alto Adige. The Tre Venezie offers a combination of geography and climate well suited to producing high-quality grapes.

Pinot Grigio is a thin-skinned, medium acid white grape. The grape’s skin color ranges from a bluish gray to a delicate pink. During winemaking, the grapes are crushed releasing a clear juice, which is fermented minus the skins, which would otherwise add some color.

In some wine shops you can find examples of Pinot Grigio made with limited skin-contact, which are copper-colored. These wines have a greater depth of color and flavor. The Italian term for this copper-colored wine is ramato. Besides Pinot Grigio, another white wine that is made from pinkish-colored grapes is Gewürztraminer.

Grapes, like people, sometimes have alternate names; for example, Bill, Billy, Will, or Willie instead of William. Depending on their place of origin, grapes can have several or even sometimes over 100 different synonyms (names). An example is Pinot Grigio and Pinot Gris; same grape but different names depending on where it is grown. Other synonyms for Pinot Grigio are Grauer Burgunder and Ruländer (Austria and Germany).

This particular wine is pale straw-yellow in color, with light green reflections. It has a delicate aroma and flavor of apples, citrus (lemon, lime, tangerine), figs, kiwi, lychee, melon, nectarine, passion fruit, pears, watercress, and white peach. Its aftertaste is of almonds and hazelnuts.

Pinot Grigio can be paired with many types of cheese. Some of my favorites from Italy are Asiago, Bagozzo, Bel Paese, Burrata, Burrini, Fontina, Montasio, Mozzarella, Parmigiano-Reggiano, Pecorino, Robiola Piemonte, and Scamorza.

There are hundreds of brands of Pinot Grigio available in the U.S. coming from dozens of countries. Some recommended Italian Pinot Grigio brands are Alois Lageder, Eugenio Collavini, Dorigo, Barone Fini, Ronco delle Betulle, Ca’ Montini, Càvit, Ecco Domani, Elena Walch, Livio Felluga, Marco Felluga, Maso Canali, Jermann, J. Hofstätter, Santa Margherita, Santi, and Zonin.

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 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].

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Pasta Salad Caprese

By Barbara Beltrami

These times are causing us to rethink how we feed ourselves. Even as the weather brings us outdoors and procuring provisions becomes easier, it is still a challenge to come up with ideas that break away from the same old, same old kitchen fare and backyard barbecue. 

But here’s what you can do: You can park outside your favorite restaurant, order takeout, have it delivered to your car (maintaining all distancing and COVID-19 protocol, of course), and have a tailgate picnic. It will give you a break from your routine and help to support local restaurants and their employees who are struggling to recuperate from their financial losses during the pandemic. 

And if you’re just not up to takeout, but still need a change of scenery for mealtime, here is one of my favorite do-it-yourself picnic menus, tailgate or otherwise, that requires little preparation and the addition only of some fresh summer fruit and a beverage or two. So find an unpopulated space with a nice view and breeze and enjoy a little change of venue. 

Pasta Salad Caprese

Pasta Salad Caprese

YIELD: Makes 4 to 6 servings. 

INGREDIENTS: 

1 pound fusilli, shells or other short pasta

2/3 cup extra virgin olive oil

1/4 cup white wine vinegar

Salt and freshly ground pepper to taste

1 garlic clove, bruised

1 pound fresh mozzarella cheese, cubed

1 pint grape tomatoes, halved

1 1/2 cups fresh basil leaves, torn

DIRECTIONS:

Cook pasta according to package directions. While it’s cooking, in a small bowl whisk together the oil, vinegar, salt, pepper and garlic clove; set aside. When pasta is ready, drain but do not run cold water over it. Transfer to large bowl. Remove and discard garlic from oil and vinegar mixtures and while pasta is still hot, toss it with the dressing. Let sit at room temperature until ready to serve; add mozzarella, tomatoes, basil and more salt and pepper; toss again and serve immediately with frittata and wine or lemonade.

Artichoke, Asparagus and Spinach Frittata

YIELD: Makes 4 servings. 

INGREDIENTS: 

1 pound fresh baby artichokes, outer leaves trimmed

6 extra large eggs

Salt and freshly ground black pepper

1/4 cup snipped fresh chives

3 tablespoons chopped fresh oregano leaves

1/4 cup grated Parmesan cheese

2 cups fresh spinach leaves

1/4 cup extra virgin olive oil

1 large shallot, minced

1/2 pound asparagus, trimmed and cut into one-inch pieces

DIRECTIONS:

Sprinkle artichoke hearts generously with salt and steam until very tender, about 15 minutes. Immerse in cold water. In medium bowl beat eggs vigorously with salt, pepper, herbs and cheese; stir in spinach leaves. Preheat oven to 400 F. In a medium nonstick skillet over medium-high heat warm oil, add onion and cook, stirring frequently, until onion starts to wilt, a couple of minutes. Add artichokes and cook over medium heat, stirring frequently, until golden brown, 6 to 8 minutes

Pour in egg mixture and swirl pan to distribute evenly; distribute asparagus pieces evenly over top. Shake the skillet gently and tilt the pan while lifting the edges gently with a spatula so that liquid from center runs to outside edge of pan. Reduce heat to low, repeat tilting-lifting procedure every two minutes and cook till eggs are nearly set, about 8 to 10 minutes. Transfer frittata to upper third of oven and monitoring carefully, cook until top is light golden, about 3 minutes. Remove from oven, slide or invert onto plate, and when somewhat cooled, cover with aluminum foil. Cut into wedges and serve hot, warm or at room temperature with pasta salad and wine or lemonade.

Oatmeal and Dried Cherry Cookies

Oatmeal and Dried Cherry Cookies

YIELD: Makes 4 dozen

INGREDIENTS:

1/2 cup plus 6 tablespoons unsalted butter, softened

3/4 cup firmly packed brown sugar

1/2 cup granulated sugar

2 eggs

1 teaspoon vanilla extract

1 1/2 cups flour

1 teaspoon baking soda

1 teaspoon ground cinnamon

1/2 teaspoon coarse salt

3 cups old-fashioned uncooked oats

1 cup dried cherries, chopped

DIRECTIONS:

Heat oven to 350 F. In a large bowl with mixer on medium speed, beat butter, brown sugar and granulated sugar until fluffy and creamy; add eggs and vanilla and beat well. In another medium bowl, combine flour, baking soda, cinnamon and salt; add to butter mixture; mix well. Add oatmeal and dried cherries; mix well. Drop by rounded tablespoonfuls onto ungreased cookie sheet; bake until golden, 8 to 10 minutes. Cool one minute on cookie sheet, then finish cooling on wire rack. Store in airtight covered container.

 

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Over 30 million people in the United States suffer from some form of eczema. Stock Photo
Most treatments focus on managing symptoms of itchiness or redness

By David Dunaief, M.D

Dr. David Dunaief

Referred to more broadly as atopic dermatitis, the cause of eczema is unknown, but it is thought that nature and nurture are both at play (1). Eczema is a chronic inflammatory process that involves symptoms of pruritus (itching) pain, rashes and erythema (redness) (2).

Eczema is common in both children and adults. In the United States, it’s estimated that over seven percent of the adult population is afflicted (3), with twice as many females as males affected (4). Ranging in severity from mild to moderate to severe, adults tend to have moderate to severe eczema.

Treatments for eczema run the gamut from over-the-counter creams and lotions to prescription steroid creams to systemic (oral) steroids and injectable biologics. Some use phototherapy for severe cases, but the research on phototherapy is scant. Antihistamines are sometimes used to treat the itchiness. Also, lifestyle modifications may play an important role, specifically diet. Two separate studies have shown an association between eczema and fracture, which we will investigate further.

Let’s look at the evidence.

Eczema isn’t just superficial

Eczema may also be related to broken bones, according to several studies. For example, one observational study showed that those with eczema had a 44 percent increased risk of injury causing limitation and an even more disturbing 67 percent risk of bone fracture and bone or joint injury for those 30 years and older (5). And if you have both fatigue or insomnia and eczema, you are at higher risk for bone or joint injury than having one or the other alone. One reason for increased fracture risk, the researchers postulate, is the use of corticosteroids in treatment.

Steroids may weaken bone, ligaments and tendons and may cause osteoporosis by decreasing bone mineral density. Chronic inflammation may also contribute to the risk of bone loss. There were 34,500 patients involved in the study, ranging in age from 18 to 85. For those who have eczema and have been treated with steroids, it may be wise to have a DEXA (bone) scan.

Supplements’ effectiveness

The thought of supplements somehow seems more appealing for some than medicine. There are two well-known supplements for helping to reduce inflammation, evening primrose oil and borage oil. Are these supplements a good replacement for – or addition to – medications? The research is really mixed, leaning toward ineffective.

In a meta-analysis (involving seven randomized controlled trials, the gold standard of studies), evening primrose oil was no better than placebo in treating eczema (6). The researchers also looked at eight studies of borage oil and found there was no difference from placebo in terms of symptom relief. One positive is that these supplements only had minor side effects. But don’t look to supplements for significant help.

Injectable solutions

Dupilumab is a biologic monoclonal antibody (7). In trials, this injectable drug showed good results, improving outcomes for moderate to severe eczema sufferers when topical steroids alone were not effective. Like any drug therapy, it is not without side effects, though.

Topical probiotics

When we think of probiotics, we think of taking a pill. However, there are also potentially topical probiotics with atopic dermatitis. In preliminary in-vitro (in a test tube) studies, the results look intriguing and show that topical probiotics from the human microbiome (gut) could potentially work as well as steroids (8). This may be part of the road to treatments of the future. However, this is in very early stage of development.

What about lifestyle modifications?

In a Japanese study involving over 700 pregnant women and their offspring, results showed that when the women ate either a diet high in green and yellow vegetables, beta carotene or citrus fruit there was a significant reduction in the risk of the child having eczema of 59 percent, 48 percent and 47 percent, respectively, when comparing highest to lowest consumption quartiles (9).

Elimination diets may also play a role. One study’s results showed when eggs were removed from the diet in those who were allergic, according to IgE testing, eczema improved significantly (10).

From an anecdotal perspective, I have seen very good results when treating patients who have eczema with dietary changes. My patient population includes about 15 to 20 percent of patients who suffer some level of eczema. For example, a young adult had eczema mostly on the extremities. When I first met the patient, these were angry, excoriated, erythematous and scratched lesions. However, after several months of a vegetable-rich diet, the patient’s skin had all but cleared.

I also have a personal interest in eczema. I suffered from hand eczema, where my hands would become painful and blotchy and then crack and bleed. This all stopped for me when I altered my diet many years ago.

Eczema exists on a spectrum from annoying to significantly affecting a patient’s quality of life (11). Supplements may not be the solution, at least not borage oil or evening primrose oil. However, there may be promising topical probiotics ahead and medications for the hard to treat. It might be best to avoid long-term systemic steroid use; it could not only impact the skin but also may impact the bone. Lifestyle modifications appear to be very effective, at least at the anecdotal level.

References:

(1) Acta Derm Venereol (Stockh) 1985;117 (Suppl.):1-59. (2) uptodate.com. (3) J Inv Dermatol. 2017;137(1):26-30. (4) BMC Dermatol. 2013;13(14). (5) JAMA Dermatol. 2015;151(1):33-41. (6) Cochrane Database Syst Rev. 2013;4:CD004416. (7) Medscape.com. (8) ACAAI 2014: Abstracts P328 and P329. (9) Allergy. 2010 Jun 1;65(6):758-765. (10) J Am Acad Dermatol. 2004;50(3):391-404. (11) Contact Dermatitis 2008; 59:43-47.

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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Bruce Stillman. Photo from CSHL

By Daniel Dunaief

Bruce Stillman, the CEO of Cold Spring Harbor Laboratory, last week won the Dr. H.P. Heineken Prize for Biochemistry and Biophysics, which is considered the most distinguished scientific prize from the Netherlands.

The prize, which has been awarded to 13 researchers who have gone on to win Nobel Prizes, includes a $200,000 award and a crystal trophy.

Stillman earned the award, which began in 1964 and is given every two years in categories including Medicine, Environmental Sciences and History, for his decades of work on mechanisms involved in the replication, or copying, of eukaryotic DNA.

The understated Stillman, who was born and raised in Australia, expects he’ll put the prize money into a foundation, although he hasn’t thought much about it given the other concerns that dominate his time, including not only running his own lab amid the COVID-19 pandemic but also overseeing a facility where he has been the Director since 1994 and its CEO since 2003.

Stillman said the lab has had “extensive discussions” among the faculty about whether to pursue additional research fields on an ongoing basis to combat the current virus as well as any future public health threats.

While CSHL is not an infectious disease center, the facility does have a historical precedent for contributing to public health efforts during a crisis. Indeed, during World War II, the laboratory helped create a mutated strain of fungus that increased its yield of the drug penicillin.

At this point, CSHL does not have a high containment facility like Stony Brook University where it can handle highly infectious agents.

“We may have to have one here,” Stillman said. “The reality is there are tons of infectious diseases” and the lab might need to repurpose its scientific skills towards coming up with answers to difficult questions.

Even without such a Biosafety Level 3 designation, CSHL researchers have tackled ways to understand and conquer COVID-19. Associate Professor Mikala Egeblad has been exploring whether neutrophil extracellular traps, which are ways bodies fight off bacterial infections, are playing a role in blood clotting and severe respiratory distress.

These NETS may be “promoting severe symptoms in COVID,” Stillman said. Egeblad is working on a case study with several other collaborators who have focused on these traps. Egeblad is also studying the effectiveness of NETS as a biomarker for the most severe patients, Stillman said.

CSHL is also investigating a small molecule compound to see if it inhibits viral infection. Researchers including Assistant Professor Tobias Janowitz are about to participate in a combined Northwell Health-CSHL double blind study to determine the effectiveness of famotidine, which is the active ingredient in the ulcer-treating medication Pepcid.

The coronavirus treatment, which will include patients who don’t require hospitalization, would require a higher dose than for heartburn.

As a part of this study, the scientists will use a patient tracking system that has been used for cancer to determine the effectiveness of the treatment through patient reporting, without requiring laboratory tests.

Stillman is pleased with how CSHL has “repurposed ourselves quickly, as have many institutions around the world.” He highlighted the constructive interactions among scientists.

The public health crisis has “generated a different kind of behavior in science, where there’s a lot of interaction and cooperation,” Stillman said. The preprint journal BioRxiv, which CSHL operates, has had nearly 5,000 papers about COVID-19 since January. The preprints have “not only helped disseminate information rapidly [to the scientific community], but they are also “being used to determine policy by government leaders.”

Stillman urged scientists to apply the same analytical technique in reading preprinted research that they do with peer-reviewed studies, some of which have required corrections.

As for the government’s response, Stillman believes a retrospective analysis will provide opportunities to learn from mistakes. “I don’t think the [Centers for Disease Control and Prevention] has done a very good job,” he said. He suggested that the well-documented problems with the roll out of testing as community transmission was increasing, was a “disaster.”

The CSHL CEO also said the balkanized medical system, in which every state has a different system and even some local communities have their own processes, creates inefficiencies in responding to a fluid and dangerous public health crisis.

Coordinating those efforts “could have been done very, very rapidly to develop a modern, clear [polymerase chain reaction] test of this virus and yet states and federal agencies had regulations about how these tests can be approved and controlled and regulated that are far too bureaucratic and did not set a national standard quickly,” he said.

He hopes agencies like the CDC, FDA and the Biomedical Advanced Research and Development Authority have better coordination. The country needs a national response, like it had after the Homeland Security effort following 9/11.

Optimistically, Stillman expects a therapeutic antibody will be available by the end of the summer to treat COVID-19. The treatment, which will use monoclonal antibodies, will likely be injectable and will be able to prevent infection for a month or two. These treatments could also help limit the severity of symptoms for people who have been infected.

Regeneron has taken the same approach with Ebola effectively. Stillman doesn’t think such treatments can be used with everybody in the world, which increases the need to develop a vaccine. Creating a safe vaccine, which could be available as early as next year, is a “massive, under-recognized undertaking.”

Between now and next year, a second wave of the virus is certainly possible and may be likely, given that other coronaviruses have been seasonal. 

“This happened with the influenza pandemic a century ago, so we have to be careful about this,” Stillman said. He believes that the medical community has learned how to treat severe patients, which should help mitigate the effects of a second wave in the United States. 

That may not be the case in developing countries, which is a “concern,” he said.

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Luna Moths are among the largest moth species in North America.

By John L. Turner

With a 65th birthday looming on the horizon for later this summer, I recently found myself, not surprisingly, thinking about “Bucket Lists” — lists comprising places to visit or things to do before “kicking the bucket.” It’s a concept made popular from the movie “The Bucket List,” starring Morgan Freeman and Jack Nicholson as two terminally ill older men living out their last desires, and the impending birth date — signaling a lifetime spanning two-thirds of a century — motivated me to develop “bucket list” priorities for the time I have left.

So I began to think about different types of bucket lists. Travel destinations with my family; bird trips; visits to major league baseball stadiums (been to about half of them) and, of course, the ultimate global nature bucket list — snorkeling with Whale Sharks in the coastal waters off Belize, witnessing the Wildebeest migration in the African Serengeti, sitting quietly near any one of our closest relatives — Chimpanzees, Gorillas, Bonobos, or Orangutans in the tropical forests of African and Asian countries — or walking in reverence amidst tens of millions of Monarch Butterflies at their winter roost in the highland fir forests of Mexico.

But there will be no exotic far-flung places for this article; this bucket list is more modest in scope, relating to natural phenomena that I long to see on Long Island. For a few of these, I’ve witnessed them many years ago but for others I await the first experience.

Here goes:

Seeing a Smooth Green Snake 

 Of the nearly dozen native snake species found on Long Island, undoubtedly the most beautiful is the Smooth Green Snake. It is a tropical lime green color on top and lemon yellow on its belly with a golden-colored eye. They are a bit wider than a pencil with adults reaching about two feet in length. You’d think such a brightly colored snake would stand out but laying motionless in grass they can disappear. I have never seen one on Long Island or anywhere else and would love to!

While on the subject of snakes I’d also love to see a Hognose Snake again and especially one performing its famous ‘death feign’ act. I’ve seen this behavior twice in my life, once on Long Island, but both experiences were decades ago. If disturbed the snake often but not always feigns its death by writhing spasmodically and rolling onto its back and abruptly “dies”. Adding to the convincing nature of the act the Hognose can even spill blood from its mouth by rupturing capillaries that line it. Of course, it’s all a ruse to stop a potential predator from attacking.

Finding an Ovenbird nest 

 In larger woodlands the Ovenbird sings out with its ringing teacher! teacher! song filling the spaces between and under the trees. With a little bit of luck you might find this songbird perched on a branch in the sub-canopy as it sings, its little warbler body shaking as song spills forth loudly. Despite years of searching on many a forest floor I’ve never found their “Dutch oven”-shaped nest which gives the bird its name. 

Twice in the Pine Barrens, once in Shoreham, the other in Riverhead, I’ve made a concerted effort to look for their nests, after observing nearby adults with food in their mouths. On my knees I very slowly and carefully inspected the forest floor starting where I thought, based on the bird’s behavior, the nest might be. Methodically, I spiraled outward in my search but, alas, despite half an hour of on-my-knees-searching came up empty.

Spotting a Giant Silk Moth 

Buck Moth

If you want to familiarize yourself with a remarkable, stunning, spectacular (fill in your own adjective here once you’ve seen what they look like) group of insects native to Long Island, check out photos of the following moth species: Luna, Cecropia, Polyphemus, Promethea, and Buck Moths. These are among the largest flying insects we have with wingspans as large as six inches. 

At one time they were common but no more. The host trees they depend upon as caterpillars are still relatively common to abundant on Long Island so its not a loss of food that explains their decline; widespread spraying of poisonous pesticides is the suspected cause for their significant drop.

The last of three live Luna Moths I’ve seen on Long Island was a decade ago. I’ve never seen a live Promethea or Cecropia and the last Polyphemus was six years ago — a ragged individual so beat up from bird strikes it was weakly fluttering along the asphalt in a shopping center parking lot. I scooped it out of harm’s way but it died later that day. 

Fortunately, the beautiful black, orange, and white Buck Moth, one of the iconic species of the Pine Barrens, is still common. Spared from spraying in its vast Pine Barrens forests, the Buck Moth can be observed during the day flying around the dwarf pines of Westhampton in the autumn as male moths seek out females to create the next generation.

Seeing a River Otter 

One of the bits of good news relating to Long Island wildlife is the sustained natural reintroduction of river otters, presumably from wandering individuals emigrating from Westchester and western Connecticut and island hopping to the North Fork via the island archipelago of Plum, Little Gull, Great Gull, and Fisher’s Islands. However the prospecting animals did it, they’re here now. And while I’ve seen wild otters in locations off Long Island and seen otter signs on Long Island, in the form of otter runs and scat (fishy poop) as close by as Frank Melville Memorial Park in Setauket, I’ve not seen one of these charismatic creatures here.

Observing a Mola mola  

Mola mola

This strange looking enormous fish (in fact it really doesn’t look like a fish) is often seen by fisherman and whale watchers afloat in the Atlantic Ocean in the summer. Also known as the ocean sunfish, they are world’s largest bony fish weighing in at more than one thousand pounds. They can dive deeply and after returning from cold ocean depth, they warm up by turning on their side to bask in the sun, showing off a flattened profile, a view that many (except me!) have enjoyed.

Do you have a nature-themed bucket list?

A resident of Setauket, John Turner is conservation chair of the Four Harbors Audubon Society, author of “Exploring the Other Island: A Seasonal Nature Guide to Long Island” and president of Alula Birding & Natural History Tours.

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Long Islanders marched down Smithtown’s Main Street June 7. Photo by Rita J. Egan

One thing we should all find comfort in is that people are not willing to let injustice go unanswered.

Anyone who has a shred of decency and an ounce of moral concern knows that what happened to Minneapolis man George Floyd was brutal, cruel and a significant abuse of power. Police officer Derek Chauvin placed his knee on the neck of a man for just under nine minutes, despite video evidence showing he did not present any danger to officers at the scene. Three other police officers looked on while Floyd called out for his mother, dying, without them raising a finger to help or make any point of protest. 

To some, this seems just a singular instance of cruelty, but for the massive numbers of protesters rallying and marching around the country, and now the world, it was just another instance of continued injustice on our minority communities. That is why the protests have been nearly unrelenting. That’s why the movement has spread to all parts of the country, including our backyard.

So far on Long Island, all protests have remained peaceful and have taken place at sites meant to facilitate large gatherings, all with a police presence. There have been some tense moments, and so far two people in Suffolk have been arrested relating to a protest in Shirley, but nowhere on Long Island have we seen the violence taking place in major cities. It’s important we recognize that while those protests have seen injury to both protesters and cops as well as property — though let’s remember that the life of any one individual vastly outweighs any and all damage to structures — there are many instances of police using extreme force on protesters, medics and journalists, as if proving the very point of the need to end such injustice.

But though those kinds of protests are not happening on Long Island, by reading some residents’ opinions on social media, you would think protesters are all walking down suburban streets ready to attack anyone who crosses their paths.

Activists across Long Island have been working very hard to maintain civility with these protests against injustice. That’s not to say events haven’t gotten heated, as in the case with protests in Merrick which faced plenty of racist sentiment and in Smithtown where one young man claims he and his friends were attacked. In Huntington, one restaurant owner came under fire for being caught making racist comments about “throwing watermelons at protesters” as they marched through downtown. He has since made a video apologizing for his remarks.

We all have to understand why these people rally and march. Long Island remains a very segregated place, as evidenced by a three-year Newsday report displaying racial bias on the part of many real estate agents and agencies. The COVID-19 pandemic has only laid bare the inadequacies, as minority communities have been disproportionately infected while their schools have struggled harder than most to teach their children when many don’t have access to online technology.

We commend the conscientious work of protest leaders, activists, local officials and police to facilitate these rallies and make sure they remain on point and peaceful, and also protect those who rally from being the target of violence as well.

To those residents who look on protesters with concern, often the best way to understand them is to simply speak with them. Start a dialogue. Understand where they’re coming from. Protests such as these aren’t designed to give certain populations benefit over others, but to reach an equality mandated under the words of the Constitution.

Just remember, if you yourself say you can separate good cops from bad cops, then you can separate peaceful protesters from rioters.

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METRO photo

By Daniel Dunaief

Daniel Dunaief

Hi, welcome to my store. It’s so good to see you after all these years. It hasn’t been years, I know, but it just feels like it because I’ve been a prisoner at home with my teenage children who have decided they are allergic to cooking, cleaning or almost anything else that has to do with helping around the house.

But, hey, this isn’t about me, it’s about you. You’re looking well, thank goodness. That’s the most important thing, right? This virus has been so hard on everyone, but I promised I wouldn’t say anything about the virus today.

Anyway, we have decided to move to a high touch environment because we can only have two people in our store at a time and one of them is me, which means you’ll have to leave the child you’re carrying in the stroller outside. 

You don’t have a stroller? No problem. I have a disinfected stroller just for this occasion that I can bring out from the back for you. In fact, I’m happy to sell it to you at a bargain price because I haven’t sold much of anything these days. I tried selling food to my teenage kids, but they just said I was a terrible cook, they weren’t hungry or they would be in their rooms and I shouldn’t bother them until 2021.

Oh, wait, there, I did it again. I’m so sorry. Silly me, I’m talking about myself. And, whoops, I see from your frown that you’re not happy I touched your shoulder when I made that joke. I have to make sure I socially distance. In fact, I have this new touch-the-shoulder-in-a-joking-way stick that’s exactly six feet long which I would also be happy to sell to you. I know it looks like two yard sticks taped together, which it kind of is, but it guarantees that you’ll be six feet away from everyone else. 

Yes, of course, I’m fine. Why do you ask? I’m so happy we’re entering Phase Two this week, you know? It’s a relief. I’m desperate for a haircut and I’m sure you are, too.

No, I didn’t mean to say that I thought you needed a haircut. Your hair looks great and the customer is always right.

Anyway, so I see you’re looking at those boots over there. What an excellent choice! You clearly have an eye for high fashion. I’m sure my daughter, who is on the other side of the plexiglass, wouldn’t mind taking them off and selling them to you.

Oh, you want new ones? Well, that may take a while because our shipment is in quarantine. Oh, no, wait, the shipment hasn’t even reached quarantine yet, so, ha ha, how about if you glance through the rest of the store while I pretend to read this dystopian book that I thought might be a good idea before we started to live in a dystopian society. 

What’s that? Oh, well, I’ve had a few cups of coffee this morning because I thought I’d need to be my sharpest and this stupid book kept me up all night. But, hey, I’m like a phoenix, returning to the world of selling and socializing and connecting with my customers, because that, after all, is the key to being successful in business.

Wait, no, please, don’t leave. I know your child is outside screaming. You can bring her in. It’s fine, really. In fact, can I give you a hug? I was kidding. That was a test and you passed, so, yay for you.

Oh, I see you’re really going. Well, tell your friends about the store. Did I mention that your hair looks great?

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METRO photo

By Leah S. Dunaief

Leah Dunaief

This is the year we all disappeared behind our masks. “Who is that masked man?” people would ask about the Lone Ranger, as he rode the range decades ago in every child’s imagination and kept the peace. Now they might ask the same question of us, masked men and women and children, as we peacefully go about our new freedoms of shopping and ordering meals for alfresco dining. We are not always immediately recognizable behind the variety of face coverings we see on the streets. The importance of wearing a mask has been accepted by almost everyone, and with good reason. An example of the benefits can be found in Japan.

According to Motoko Rich, a reporter for The New York Times, face coverings are common in Japan during flu and hay fever seasons, on crowded public transportation when commuters commonly have colds and even when women “don’t want to bother putting on makeup.” Mask sightings are routine.

Could that be the explanation for Japan’s surprisingly low number of victims of COVID-19 compared to other countries?

Initially, we Americans were advised not to wear masks, that they were unnecessary and should be saved for hospital workers. We all know what happened next. Cases of novel coronavirus spiked and the number of deaths exceeded the capacity of morgues and funeral homes for weeks. We were directed to shelter-in-place. Yet in Japan, which did not order a lockdown or massive testing or emphasize social distancing, and kept karaoke bars open and public transportation packed, terrible spikes in cases and deaths did not occur. The numbers there were 17,000 infections and 900 deaths. Yes, they have a smaller population, but in the United States, whose residents number two-and-one-half times that of Japan, some 1.9 million have fallen ill and 110,000 have died.

Eventually bars and businesses did close, and schools were shut early, as cultural and sports events were canceled, but note that none of those restrictions was mandatory. What the people did do was to nearly universally don masks. That response follows a cultural tradition of hundreds of years. Between the 17th and 19th centuries, mining workers used masks to prevent inhaling dust. The Japanese wore them during the 1918 flu epidemic and more recently during SARS and MERS outbreaks, as well as to protect against pollution and pollen. The country was “relatively unscathed,” during the epidemics, according to Motoko Rich.

Members of the scientific community weigh in on the matter. “I think there is definitely evidence coming out of COVID that Japan, as well as other countries which practice mask-wearing, tend to do much better in flattening the curve,” said  Akiko Iwasaki, a professor of immunobiology at Yale, as quoted in the NYT. 

Masks can block respiratory droplets that are emitted when people speak, cough or sneeze. Those droplets may carry the virus, even when the wearer has no symptoms, and hence transmit the disease if not captured by the mask.

The reporter goes on to emphasize that masks alone are not sufficient to prevent disease, that social distancing is also required. Even with masks, crowds are a danger for the spread of infection. It will be informative to learn the unintended health consequences of the many protests against racism, triggered by George Floyd’s death under the knee of a police officer, that have occurred over the past two weeks. Most of those protesters, crowded together, seemed to be wearing masks.

From my travels to Japan, I would add a couple of cultural differences to this story. We found the Japanese to bow rather than shake hands and to be a little physically distant with each other rather than hugging often. Their country is, for the most part, amazingly clean and uncluttered, and they seem fastidious about themselves. These traits would also argue in favor of less contagion when disease is present.

I would also like to predict that masks — designer, decorated, color coordinated, whatever — will be with us well after the pandemic ends.

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As a general goal, aim for at least 30 minutes of moderate physical activity every day. METRO photo
Low inflammation may play a significant role in healthy aging

By David Dunaief, M.D.

Dr. David Dunaief

What does it mean to you to “grow old gracefully?” For people I speak with, it means to be independent, mobile, mentally alert, and not burdened by chronic illnesses. In other words, to maintain a good quality of life.

The number of 90-year-olds is growing by leaps and bounds. According to the National Institutes of Health, those who were more than 90 years old increased by 2.5 times over a 30-year period from 1980 to 2010 (1). This group is among what researchers refer to as the “oldest-old,” which includes those aged 85 and older.

What do these people have in common? According to one study, they tend to have fewer chronic morbidities or diseases. Thus, they tend to have a better quality of life with a greater physical functioning and mental acuity (2).

In a study of centenarians, genetics played a significant role. Characteristics of this group were that they tended to be healthy and then die rapidly, without prolonged suffering (3).

Factors that predict one’s ability to reach this exclusive club may involve both genetics and life-style choices. Let’s look at the research.

Exercise

We are told time and time again to exercise. But how much do we need, and how can we get the best quality? In a 2014 study, the results showed that 5 to 10 minutes of daily running, regardless of the pace, can have a significant impact on life span by decreasing cardiovascular mortality and all-cause mortality (4).

Amazingly, even if participants ran fewer than six miles per week at a pace slower than 10-minute miles, and even if they ran only one to two days a week, there was still a decrease in mortality compared to nonrunners. Here is the kicker: Those who ran for this very short amount of time potentially added three years to their life span. There were 55,137 participants ranging in age from 18 to 100 years old.

An accompanying editorial to this study noted that more than 50 percent of people in the United States do not meet the current recommendation of at least 30 minutes of moderate exercise per day (5).

Diet

A long-standing paradigm has been that we need to eat sufficient animal protein. However, cracks have developed in this theory, especially as it relates to longevity. In an observational study using NHANES III data, results show that those who ate a high-protein diet (greater than 20 percent from protein) had a twofold increased risk of all-cause mortality, a four-times increased risk of cancer mortality and a four-times increased risk of dying from diabetes (6). This was over a considerable duration of 18 years and involved almost 7,000 participants ranging in age at the start of the study from 50 to 65.

However, this did not hold true if the protein source was plants. In fact, a high-protein plant diet may reduce the risks, not increase them. The reason, according to the authors, is that animal protein may increase insulin growth factor-1 and growth hormones that have detrimental effects on the body.

Interestingly, those who are over age 65 may benefit from more animal protein in reducing the risk of cancer. However, there was a significantly increased risk of diabetes mortality across all age groups eating a high animal protein diet. The researchers therefore concluded that lower animal protein may be wise at least during middle age.

The Adventists Health Study 2 trial reinforced this data. It looked at Seventh-day Adventists, a group that emphasizes a plant-based diet, and found that those who ate animal protein up to once a week had a significantly reduced risk of dying over the next six years compared to those who were more frequent meat eaters (7). This was an observational trial with over 73,000 participants and a median age of 57 years old.

Inflammation

In the Whitehall II study, a specific marker for inflammation was measured, interleukin-6. The study showed that higher levels did not bode well for participants’ longevity (8). In fact, if participants had elevated IL-6 (>2.0 ng/L) at both baseline and at the end of the 10-year follow-up period, their probability of healthy aging decreased by almost half.

The takeaway from this study is that IL-6 is a relatively common biomarker for inflammation that can be measured with a simple blood test offered by most major laboratories. This study involved 3,044 participants over the age of 35 who did not have a stroke, heart attack or cancer at the beginning of the study.

The bottom line is that, although genetics are important for longevity, so too are lifestyle choices. A small amount of exercise, specifically running, can lead to a substantial increase in healthy life span. 

Protein from plants may trump protein from animal sources in reducing the risk of mortality from all causes, from diabetes and from heart disease. This does not necessarily mean that one needs to be a vegetarian to see the benefits. IL-6 may be a useful marker for inflammation, which could help predict healthy or unhealthy outcomes. Therefore, why not have a discussion with your doctor about testing to see if you have an elevated IL-6? Lifestyle modifications may be able to reduce these levels.

References:

(1) nia.nih.gov. (2) J Am Geriatr Soc. 2009;57:432-440. (3) Future of Genomic Medicine (FoGM) VII. Presented March 7, 2014. (4) J Am Coll Cardiol. 2014;64:472-481. (5) J Am Coll Cardiol. 2014;64:482-484. (6) Cell Metab. 2014;19:407-417. (7) JAMA Intern Med. 2013;173:1230-1238. (8) CMAJ. 2013;185:E763-E770.

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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