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Taking calcium may only help if you’re deficient

By David M. Dunaief, M.D.

Dr. David Dunaief

We should all be concerned about osteoporosis risk. According to the Bone Health & Osteoporosis Foundation, 50 percent of women and 25 percent of men will break at least one bone due to osteoporosis (1). Hip fractures are especially concerning, because they increase mortality risk dramatically. More than 50 percent of hip fracture survivors are no longer able to live independently (2).

Do we need to consume more dairy?

Studies suggest that milk and other dairy products may not be as beneficial as we have been raised to believe.

Studies have shown milk may not be beneficial for preventing osteoporotic fractures. Specifically, in a meta-analysis that used data from the Nurses’ Health Study for women and the Health Professionals Follow-up Study for men, neither men nor women saw any benefit from milk consumption in preventing hip fractures (3).

In a 2020 meta-analysis of several past studies, researchers concluded that increased consumption of milk and other dairy products did not lower osteoporosis and hip fracture risks (4).

Generally, studies suggest that dairy may cause additional health problems. The results of a large, 20-year, observational study involving men and women in Sweden showed that milk may be harmful (5). When comparing those who consumed three or more cups of milk daily to those who consumed less than one, there was a 93 percent increased risk of mortality in women between the ages of 39 and 74. 

Dosage also mattered. For every one glass of milk consumed, there was a 15 percent increased risk of death for women. There was a much smaller, but significant, three percent per glass increased risk of death in men. For both women and men, researchers found biomarkers in the urine that indicated higher levels of oxidative stress and inflammation.

Remember: these are only associations, not decisive conclusions. The researchers surmise that milk has high levels of D-galactose, a simple sugar that may increase inflammation.

Interestingly, the USDA recommends that, from the age of 9 through adulthood, we consume about three cups of dairy per day (6).

Should we take calcium supplements?

We know calcium is a required element for strong bones, but do supplements really prevent osteoporosis and subsequent fractures? While the data are mixed, it suggests supplements may not be the answer for those who are not calcium deficient.

In a meta-analysis involving a group of observational studies, there was no statistically significant improvement in hip fracture risk in those men or women ingesting at least 300 mg of calcium from supplements and/or food daily (7).

The researchers did not differentiate among the types of foods containing calcium. In a group of randomized controlled trials analyzed in the same study, those taking 800 to 1,600 mg of calcium supplements per day also saw no increased benefit in reducing nonvertebral fractures. In four clinical trials, the researchers saw an increase in hip fractures among those who took calcium supplements. A weakness of this large study is that vitamin D baseline levels, exercise and phosphate levels were not considered in the analysis.

Does vitamin D supplementation reduce risk?

Finally, though the data are not always consistent for vitamin D, it appears it may be valuable when it comes to fracture prevention. In a meta-analysis involving 11 randomized controlled trials, vitamin D supplementation resulted in fewer fractures (8). When patients were given a median dose of 800 IUs (ranging from 792 to 2,000 IUs) of vitamin D daily, those who were aged 65 and over experienced a 14 percent reduction in nonvertebral fractures and an even greater 30 percent reduction in hip fractures. However, vitamin D in lower levels did not significantly reduce fracture risk.

Where does that leave us?

Our knowledge of dietary approaches is continually evolving. Dairy’s role may be an example of this. No definitive statement can be made about calcium, although even in randomized controlled trials with supplements, there was no significant benefit. However, the patients in these trials were not necessarily deficient in calcium nor vitamin D.

To prevent fracture, older patients may need at least 800 IUs of vitamin D supplementation per day.

Remember that treatment and prevention approaches should be individualized, and deficiencies in vitamin D or calcium should usually be treated, of course. Please, talk to your doctor before adding or changing any supplements.

References: 

(1) www.bonehealthandosteoporosis.org. (2) EndocrinePractice. 2020 May;26(supp 1):1-46. (3) JAMA Pediatr. 2014;168(1):54-60. (4) Crit Rev Food Sci Nutr. 2020;60(10):1722-1737. (5) BMJ 2014;349:g6015. (6) health.gov. (7) Am J Clin Nutr. 2007 Dec;86(6):1780-1790. (8) N Engl J Med. 2012 Aug. 2;367(5):481.

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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Barbara Palazzo taking the CatchU test.

By Daniel Dunaief

A significant concern for the elderly, falls create health problems that affect the quality of life and generate significant expense.

Stony Brook University’s Jeannette Mahoney, Professor of Neurology and Chief of the Division of Cognitive and Sensorimotor Aging in the Renaissance School of Medicine, has developed a smartphone app called CatchU that is designed to alert patients and their doctors to the potential likelihood of falls.

Jeannette Mahoney with her grandmother Jean Sisinni, who died from a fall and for whom she’s dedicated the work on CatchU.

The National Institute of Aging (NIA) recently named CatchU as one of 21 finalists out of 275 entrants around the country for its Start-Up Challenge. As a finalist, Mahoney received $10,000, recently participated in entrepreneurial training sessions, and is receiving one on one mentorship.

“Falls are a leading cause of injury and death for older adults, including persons living with Alzheimer’s Disease,” Joy Toliver, Program Analyst at the National Institute of Aging explained. CatchU is a “novel approach” that has the potential to “expand access to high-quality, comprehensive fall risk assessments and to improve the health and quality of life of older adults.”

If CatchU is chosen as one of seven winners in the next stage of the challenge, Mahoney, through her company JET Worldwide Enterprises, is also eligible to receive $65,000.

Previous participants in a challenge that is now in its third year have gone on to raise significant equity funding, secure multiple grants and form partnerships with health systems to expand the impact of their solutions, Toliver added.

An ‘honor’

“I’m super stoked — it’s really such an honor to be selected by members of the NIA that believe in you, your science and your product,” Mahoney said.

A photo of the CatchU app courtesy of JET Worldwide Enterprises Inc.

She plans to use the prize money she’s received so far to help with app enhancements, legal fees for review of new service agreements, and exclusive license obligations.

The app links impaired multisensory integration, in which people combine information from visual and other cues, with poor motor outcomes. Mahoney has been working in this field for about a decade. Through a 10-minute health app that monitors reaction time as a person is asked to respond as quickly as possible to targets they can see, feel or see and feel at the same time, CatchU provides a quantitative risk for falls.

Across the country, about three million older Americans require an Emergency Room visit each year as a result of fall-related injuries.

Closer to home, Suffolk County residents from 65 to 74 are hospitalized at the rate of 106 per 10,000, while those number increase with each decade. From 75 to 84, residents require hospitalization at a rate of 311 per 10,000. People in the county who are over 85 visit hospitals after falls at the rate of 821 per 10,000, according to the Suffolk County Community Health Assessment and Improvement Plan.

For seniors over 75 years old in Suffolk County the hospitalization rate from falls exceeded that for the state exclusive of the city by more than 30 percent.

According to research Mahoney has done, older adults with poor multisensory integration are 24 percent more likely to fall than those with intact multisensory integration.

“We believe that results of the CatchU test will likely change over time for better or worse depending on levels of remediation,” she explained. “Our goal is to uncover what type of remediation (whether it is sensory, cognitive, or motor focused or some combination), and what duration/ frequency is most beneficial in subsequent clinical trials.”

Mahoney envisions using CatchU as a new standard of care for predicting fall propensity in adults 65 and over. Depending on performance, people could receive remote testing every six to 12 months.

Possible remediation

While people could download the app today, they wouldn’t be able to take the test without a provider code. Doctors would receive the results of their tests directly and could offer a range of recommended actions. This could include tai chi, physical therapy, core balance, strength training or other exercises.

Mahoney and her colleagues are running a clinical trial in Westchester County. The study attempts to determine whether integration measured on CatchU is comparable to integration measured on the lab apparatus. They submitted this research for publication.

The clinical trial also seeks to determine whether older adults with poor multisensory integration that receive feedback about their CatchU performance would go on to fall less often or have a longer time to fall compared to older adults with poor multisensory integration who did not receive any such specific feedback.

Alzheimer’s assessment

CatchU could provide beneficial information for people who might develop Alzheimer’s Disease.

From what Mahoney and her colleagues can tell, the same simple reaction time test taps into inter-related sensory, motor and cognitive neural circuits that are all affected by aging and/or disease.

Mahoney has shown that an ability to integrate sensory information is associated with higher amyloid burden, which is a known biomarker for Alzheimer’s Disease.

“Our current R01 project work will help us uncover the exact structural and functional neural correlates of impaired multisensory integration, which may shed light on the specific outcome measures that are adversely affected by poor integration,” Mahoney explained.

A returning Seawolf

Mahoney rejoined Stony Brook University in October, over 22 years after she graduated from the downstate flagship SUNY school with a bachelor of arts degree in Psychology and Social Science. She described coming back to campus as a “surreal” experience and appreciates how her colleagues have been“super helpful and supportive.”

Mahoney lives in upstate Stony Point with her husband Timmy, their 14 year-old daughter Kayleigh and 10-year old son Peter.

Mahoney formed the company JET Worldwide Enterprises almost exactly five years ago. It is based in Stony Point and has two employees. The company name, JET, comes from a nickname for Mahoney’s first name. If she is able to secure future funding, she hopes to move JET to incubator space at Stony Brook.

The family enjoys playing board games, including Mahjong. Mahoney learned the tile game from her mother, who learned it from Mahoney’s grandmother Jean Sissini.

Mahoney has dedicated CatchU to her grandmother, who passed away in 2021 after suffering a fall. 

While Sissini is no longer with them, the family knows she is “always with us in spirit,” Mahoney said.

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Libra

Welcome to the 42nd edition of Paw Prints, a monthly column for animal lovers dedicated to helping shelter pets find their furever home.

Libra

 

Meet Libra

The Libra personality is known for being fair-minded and having the ability to see both sides of every argument. They are renowned for their charm, diplomatic spirit, and tempered nature. A six year old Terrier mix at Little Shelter in Huntington, this Libra’s horoscope predicts a soon-to-be forever home and a bright future. Well-balanced and interesting, he has an independent personality and would prefer to be the only pet in the household, confident he can fulfill the role of best friend and loyal partner. This handsome fellow has both the spunk of a Terrier and an astrologist’s insight, so if the stars align for you, stop by to meet him today. 631-368-8770 *Libra is mostly housebroken.

Sunny

Meet Sunny

Dappy Sunny at the Smithtown Animal Shelter has a disposition that matches his name. This 80 pound 4-year-old Alaskan Malamute is sweet, attentive, smart and quite the talker! Like an old fashioned crooner, he is handsome, a gentleman and sings lament-like howls when he is feeling neglected. This breed is highly intelligent, acitve and has grooming needs that a potential home would have to be equipped to provide. Any family would be lucky to add this handsome man to their ranks.  He would do best in a home with older children and no cats. 631-360-7575.

Ricky

Meet Ricky

Little Ricky’s eyes tell the story of a soul that’s been through far too much. Rescued from death row at NYCACC, this precious Puggle arrived at the door of Save-A-Pet in Port Jefferson Station sad, confused, and suffering from painful ear and skin infections—neglect no dog should ever endure.

Despite it all, Ricky is pure sweetness. He is quiet, gentle, and full of love just waiting to be received. He’s been healing beautifully with proper medical care and a safe place to rest, and now, all he needs is a home where he can finally feel safe and cherished.

Ricky would thrive in a calm, peaceful environment, ideally with someone who understands that sometimes the most broken hearts make the most loyal companions. He’s the kind of dog who will curl up beside you, gaze at you with those soulful eyes, and remind you daily what love really looks like.

After everything he’s endured, Little Ricky  is ready to give his heart to the person who offers it to him. 631-473-6333

Maddie

Meet Maddie

Meet Maddie — a sweet, gentle 8-year-old soul with a heart full of love! Maddie came to the Brookhaven Animal Shelter as a stray, and it was clear she had been through a lot. She was found with chains tied to her collar, which she had chewed through in an effort to free herself. But despite her tough past, Maddie has proven to be resilient and incredibly loving. 

Now that she’s safe and warm in the shelter, Maddie sleeps soundly, knowing she’s in a safe place. She adores being around people, offering affection and companionship to everyone she meets. She’s a calm and loving girl, who would do wonderfully in a home with kids. Maddie deserves the chance to experience the good life she’s been waiting for. This gem of a dog is ready to be someone’s loyal, loving companion. Will that be you? 631-451-6955

Sylvie

Meet Sylvie

This petite beauty is a dilute tortie with a heart as soft as her fur. Sylvie was rescued from a high-intake shelter in Georgia and is now safe at Kent Animal Shelter in Calverton. Even after a rough start, she’s kept her gentle, loving spirit shining bright. The purr-fect mix of affectionate and independent she’ll happily curl up for some pets and attention, then retreat to her favorite perch on the cat tree to quietly watch the world go by. Sylvie would make a wonderful companion for someone looking to share peaceful days and cozy nights. She’s ready to leave her past behind and start her forever with someone who’ll treasure her. 631-727-5731, Ext.

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Pet-A-Palooza heads to Little Shelter

Join Little Shelter Animal Rescue & Adoption Center, 33 Warner Road, Huntington for its annual Pet-A-Palooza fundraiser celebration on June 14 and June 15 from 9 a.m. to 6 p.m. Featuring a huge Chinese auction, games for kids, face painting, BBQ, Blessing of the Animals service on June 15 at 3 p.m., “Dogs on Parade” dog contest, doggie swimsuit contest and many animals for adoption. Meet Anna and Raven from WALK 97.5 FM on June 14. 631-368-8770, www.littleshelter.org

Rescue is a lifestyle. Adopt, don’t shop.

Check out the next Paw Prints in the issue of July 10.

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

 

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Greek Cheeseburger

By Heidi Sutton

While Father’s Day is for honoring dads, it’s also a great opportunity to honor the men who have been father figures to us — stepfathers, grandfathers, uncles, even friends who have played that role in our lives.

This year, take some extra time to tell those men how much they’ve meant to you. A card or letter, a phone call … or have them over for a special dinner. Grill up Greek Cheeseburgers or Curried Turkey Sliders to make them feel really special. Serve with fries or a pasta salad. And don’t forget dessert!

Greek Cheeseburgers

Recipe courtesy Marcia Stanley

YIELD: Makes 5 servings

INGREDIENTS:  

Garlic Mint Sauce

3/4 cup cottage cheese, any type

1/2 cup (2 oz.) cheese, crumbled feta

1 teaspoon minced garlic

1/2 teaspoon lemon juice

2 tablespoons chopped red onion

1 teaspoon chopped fresh mint leaves

Sandwiches

1 cup cottage cheese, any type

2 tablespoons dry bread crumbs

1 tablespoon chopped fresh oregano, or 1 teaspoon dried oregano leaves

1/2 teaspoon salt

1/8 teaspoon cayenne pepper

1 pound lean ground beef

5 hamburger buns

1 1/4 cups baby Arugula

10 thin slices tomato

1/2 cup thinly sliced cucumber

DIRECTIONS:

In large bowl combine 1 cup cottage cheese, bread crumbs, oregano, salt and cayenne pepper. Add ground beef and mix well. Shape into five 1/2-inch-thick patties. Grill directly over medium heat for 10 to 13 minutes or until done (160°F), turning once. 

Line bun bottoms with arugula. Top with burgers, tomato slices, cucumber slices, Garlic Mint Sauce and bun tops and serve.

Curried Turkey Sliders

Recipe courtesy of Culinary.net

YIELD: Makes 6 servings

INGREDIENTS:  

1 pound lean ground turkey

1/4 cup finely diced onion

2 tablespoons chopped cilantro

1 1/2 teaspoons curry powder

1/2 teaspoon salt

1/4 teaspoon ground black pepper

12 mini burger or small dinner rolls split and toasted

Chutney:

2 green kiwifruit peeled, finely diced

1 tablespoon golden raisins

2 teaspoons sugar

1/8 teaspoon salt

DIRECTIONS:

Combine kiwifruit, raisins, sugar and salt in small bowl and mix. Make chutney just prior to serving. Preheat grill to medium. Combine turkey, onions, cilantro, curry powder, salt and pepper in medium bowl. Shape into 12 2-inch mini burger patties. Grill patties for 2 to 3 minutes on each side, turning once, until cooked through. Place on buns; top with chutney before serving.

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By Britt Burner, Esq.

Britt Burner Esq.

Joan, a 70-year-old woman, visits an elder law attorney and says that her biggest concern is making sure that her house is protected should she need nursing home care. She has two children and wants to make sure they are able to inherit the house after her death. However, Joan also points out that both of her children live out of state with no intention of returning. While they are both married, neither has children. J

oan is hoping that grandchildren will come along soon and knows that if they do, there is a good chance she may want to sell the house and relocate to be near her growing family. Joan is looking for a solution that gives protection to her largest asset, her home, while also providing flexibility in case she decides to move.

Protecting one’s home in a Medicaid Asset Protection Trust (MAPT) is a common planning tool and probably the best option for Joan. The MAPT is an irrevocable trust, meaning that it cannot be revoked unless the creator of the trust, Joan, and the beneficiaries agree. Joan’s children can be the trustees ,but Joan can retain the right to remove them from this position, as well as the right to change the ultimate beneficiaries of the trust. During her life, Joan can also keep the exclusive right to occupy the premises and will be responsible for the property’s maintenance, upkeep and taxes, thus not placing any additional burden upon her children.

Fast forward 5 years and Joan gets the grandkids she has been hoping for and her daughter asks her to move closer to help out. Joan loves the idea, but what about her house?

The trustees can sell the house in the name of the MAPT. Joan’s children, as trustees, will be responsible to handle the sale including signing the listing agreement, contract of sale, and closing documents. Just as if Joan had kept the house in her own name, a $250,000 exclusion from capital gains tax will apply.

The proceeds of the sale must be deposited in a bank account in the name of the trust; the trust sold the house therefore the trust gets the proceeds. From there, the trust can purchase a new house to serve as Joan’s primary residence with the same rules as the prior residence. The protection for Medicaid purposes goes back to when Joan initially put her first house into the trust, so no new clock is set since the assets never left the trust. 

If Joan decides to move in with her daughter, the assets can be left in cash or invested within the trust. Depending on how the trust is written, Joan can receive the income generated by those assets. However, in no case may Joan have access to principal from trust assets. When speaking with the elder law attorney, Joan should be upfront about the potential for a move so her concerns can be addressed. 

It may make sense, if Joan knows what state she is likely to end up in, for an elder law attorney in the second state to review a draft of the trust to make sure maximum protection can be provided whether Joan ends up needing services from Medicaid in that state.

Britt Burner, Esq. is a Partner at Burner Prudenti Law, P.C. focusing her practice areas on Estate Planning and Elder Law. Burner Prudenti Law, P.C. serves clients from New York City to the east end of Long Island with offices located in East Setauket, Westhampton Beach, Manhattan and East Hampton.

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By Daniel Dunaief

Daniel Dunaief

Why do we go to baseball games? Oooh, pick me! Pick me! I can answer. Of course you can. You’re writing this piece. Okay, let’s talk about the appeal of baseball.

First of all, there’s the potential for anything baseball related to happen. I might see a triple play, a no hitter, a perfect game, four home runs in a row, eight consecutive strike outs, or something other collections of fans have either never seen or rarely witnessed.

We recently attended a minor league game in which two runners scored on a sacrifice fly to deep center field.

Baseball is an endless series of what-if moments, as in, what if the batter hits the ball to third base with runners on first and third and one out. Is it hit hard enough for a double play based on the speed of the runners, the score at the time, and the movement of the runner on third?

The combination of athleticism and strength bring different qualities to the game. Sure, people who are big and muscular can hit a ball hard, but can they get a good jump when they’re running from first or second base, can they cover a larger strike zone, and can they be satisfied with a single or double instead of a towering home run?

Then, there’s the aesthetic appeal of the stadiums, with bright lines going out from home plate to the outfield, defined base paths, and a shimmering outfield grass (if it’s real grass), where fleet-footed fielders race to track down balls.

Two questions immediately occur to me as I reach my seat. The first is how good the view is relative to the field. Can I see pitches clearly? Can I track balls from home plate to all parts of the field?

The second is whether I’m in prime foul ball territory. Admittedly, that’s a tougher question to answer, especially with all the screens that have now gone up around the infield. 

There is something about balls flung from these fields of dreams that imbues them with a power far in excess of their raw materials. Is it the perfect weight in our hands? Is it the feel of the gently raised seams? Or, perhaps, it’s the combination of the white hard outer layer, the red seams, and the blue from the logo, the official major league baseball lettering and the signature of current commissioner Robert Manfred, Jr.

Sure, free stuff in general is fun to catch, but something about these baseballs makes bringing them home particularly rewarding, giving us a physical connection to the game.

Maybe it’s the stories we can tell about how the baseball came from a particular hitter or a specific game. Or maybe the balls, like the game itself, contain within them the power of the what-if.

Have you ever seen people after they’ve caught a ball at a game? They can’t help smiling, often examining it closely, as they look for where a bat struck it or where it rolled across the grass or dirt. 

Tossing a ball to a particularly vociferous or angry fan could serve as a pacifier. Yeah, your team is losing by 12 runs, and yes, you could have done a better job at everything because you’re that much more knowledgeable about the game than everyone else, but you have a baseball in your hand. How cool is that?

The balls from America’s pastime are like us. They may have similar qualities or look and feel the same, but they can and will be unique in and of themselves and as a part of a game. They could be the central part of a double play, the main character soaring through the air on a walk off home run, or the 18th pitch of a tremendous 21 pitch at bat.

These balls carry magic and hope. 

And, yes, if you’re wondering why I’m so rhapsodic, I caught a ball at the aforementioned minor league game. A third base coach knocked down a foul ball and tossed it directly at me in the stands. When I caught it, I handed it to my daughter, excited to share this small piece of baseball and personal history with my family and now with you. It’s just a ball and yet it’s so much more.

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METRO photo

By Leah S. Dunaief

Leah Dunaief,
Publisher

Wednesday was National Corn on the Cob Day, and when I saw that, I began to salivate because I love that vegetable. We are now coming into the season when the kernels are sweet with or without butter and salt. 

Everyone eats corn differently, it seems, if you watch people devouring the offering. I bite the corn from the cob as if I were using an old fashioned typewriter, meaning in a single row from left to right. I’ll eat one row, then go back, as if I were slinging a typewriter carriage to the next line, and chew straight above the first.

Others turn the cob so that they are eating in a circular fashion, one circle precisely after the other in a geometric display. Still others just plow right in, chewing wherever their teeth land. They eventually clean off the whole cob.

I guess one could tell a lot about the corn eater’s personality by watching the pattern of consumption from the cob.

My favorite corn on the cob story takes place in the late 1940s on a freezing January day. My dad, who grew up in the mountains and loved the cold, brisk air, would put on his heavy winter coat and take my mother, my brother, my sister and me to Coney Island. 

It was always on a Sunday, when he had off from work. The ride tickled my mother, who thought it was an extraordinary price on the subway for the same 15 cent token that one paid just to go one stop, so that typically would be part of the conversation on the trip to Brooklyn from our apartment in Midtown Manhattan. 

When we emerged from underground, the wind and cold would initially take our breaths away, but before long, we acclimated. We followed my dad down to the beach and watched the wild waves plunge into the shore with a roar and lots of foam, then recede meekly only to repeat the fury. It was Nature showing its dramatic face.

It was also intensely cold.

After a few minutes of beach walking, we would head toward Nathan’s Hot Dog stand, one of the few stores open in the winter. This one Sunday, we were in for a surprise. In the narrow alley between Nathan’s and the next building was a man with a cauldron on what I guess was an electric burner, steam pouring from the pot. As we drew near, we could see butter, salt and napkins on the stand.

When my dad cleared a hole in the steam and peered into the pot, he expressed some happy surprise. “Where did you get corn on the cob in January?” he queried the man holding the tongs.

“They are in the frozen food section of some of the supermarkets,” the man explained. Frozen foods were just beginning to appear in markets at that time.

“Do they taste the same?” my dad asked.

“Try one,” the fellow offered and plucked one from the boiling water, putting it on a piece of white paper.

When it had cooled enough to bite into the cob, my dad approved the purchase and we all ate those steaming corn with butter and salt, crowding around the cauldron for warmth. I still remember those corn as the sweetest as any I had ever tasted in the summer. 

Besides, they warmed my hands.

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The Gamecock Cottage. Photo by Heather Lynch

After the record-breaking flood of last August, an heirloom of our community fell to ruins and has yet to reconnect with the scenic roads that we are so lucky to take every day. In light of the destruction of the beautiful and historic Mill Pond in Stony Brook and Stump Pond in Smithtown, members of the community have shared an outpouring of public support and togetherness in rebuilding our local history in the past week. At the Mill Pond, residents describe feeling stranded by administrative gridlock; but perhaps it does not have to be disheartening. 

As the weather finally warms, we are looking to fill the mill-shaped gaps in our hearts, which we can do by visiting and honoring our island’s other beautiful parks. We can celebrate our rich Native American and colonial history at equally evocative and inspiring sites during  these sun-kissed summer days. 

Containing the only remaining wooden cottage part of the beach, West Meadow Beach Path offers a 2.3-mile paved stroll through the wetlands reserve, complete with local wildlife infographics, a scenic overlook at still-standing 1876 Gamecock Cottage, and a historic building constructed for storage of oars and row boats. West Meadow Beach Path eases us from the nostalgia of the wooded, breezy salt marsh at dusk to the citrus sunsets met by the water, with terrapins, herons and bunnies searching for food or calling to each other between the reeds. At dusk, we may even spot deer up close in the brush. 

At the Rocky Point Pine Barrens, archaeological evidence point to a minimum 12,000 year-long history of Native American presence in the area. The land that provided resources for hunting, gathering, and shelter now offers miles of hiking and biking trails and horseback riding. Visitors should keep an eye out for historical signage, landmarks and vegetation unique to the undeveloped land, enabling us to appreciate and respect our island’s pre-colonial history. Verdant and sprawling, the Rocky Point Pine Barrens is stimulating and invigorating as much as it is calming. A visit to the pine barrens connects us with those who called this place home long before we arrived.

Further west, Heckscher Park is the site of a former 19th-century estate bought by New York State. Within walking distance of Huntington Village, the park features the Heckscher Museum of Art, pond, walking paths, playground, tennis courts, ball field, public art and memorials in addition to the “Chapin Rainbow Stage” performing arts amphitheater, home of the Huntington Summer Music Festival. Heckscher Park bustles with joy and laughter; an “All-American” gem, a mine for summer-night nostalgia alongside new memories we can enjoy on picnic blankets.

Tracking our unique lineage and culture throughout the island is as important as fighting for what we’ve lost. We can create new memories and revel in small joys at other local treasures as we  wait for the Mill Pond and Stump Pond to recover.

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Fiber-rich foods, including whole grains, seeds and legumes, as well as some beverages, such as coffee and wine, contain measurable amounts of lignans. Stock photo
Ozempic/Mounjaro don’t substitute for lifestyle changes

By David Dunaief, M.D.

Dr. David Dunaief

Type 2 diabetes management knowledge is always evolving. Here, we will examine how some diabetes management myths hold up against recent research.

Myth: Fruit can raise your sugars

Diabetes patients are often advised to limit whole, juiced, and dried fruit, because it can raise your sugars. This is only partly true. 

Yes, you should avoid fruit juice and dried fruit, because they do raise or spike glucose (sugar) levels. This includes dates, raisins, and apple juice, which are often added to “no sugar” packaged foods to sweeten them.

This is not true for whole fruit, which can be fresh or frozen. Studies have shown that patients with diabetes don’t experience sugar level spikes from whole fruit, even when they consume them in abundance (1). Another study showed that consuming whole fruit reduces type 2 diabetes risk (2).

In a third study, researchers considered the impacts of different types of whole fruits on glucose levels. They found that berries reduced glucose levels the most, but even bananas and grapes reduced these levels (3). The only fruit tested that seemed to have a mildly negative impact on sugars was cantaloupe.

Whole fruit is not synonymous with sugar. One reason for the beneficial effect is the fruits’ flavonoids, or plant micronutrients, but another is their fiber.

Myth: You should avoid all carbohydrates

Fiber is one type of carbohydrate that has important benefits. It can reduce risks for an array of diseases and improve outcomes. This holds true for type 2 diabetes risk. 

Two very large prospective observational studies, the Nurses’ Health Study (NHS) and NHS II, showed that plant fiber helped reduce the risk of type 2 diabetes (4). Researchers looked at lignans, a type of plant fiber, specifically examining the metabolites enterodiol and enterolactone. They found that patients with type 2 diabetes have substantially lower levels of these metabolites in their urine when compared to the control group without diabetes. There was a direct relationship between the level of metabolites and the reduction in diabetes risk: the more they consumed and the more metabolites in their urine, the lower the risk. The authors encourage patients to eat a plant-based diet to get this benefit.

Foods with lignans include cruciferous vegetables, such as broccoli and cauliflower; an assortment of fruits and whole grains; flaxseed; and sesame seeds (5). The researchers could not determine which plants contributed the greatest benefit; however, they believe antioxidant activity drives this effect.

Myth: You should avoid soy

In diabetes patients with nephropathy (kidney damage or disease), consuming soy has been associated with kidney function improvements (6). There were significant reductions in urinary creatinine levels and proteinuria (protein in the urine), both signs that the kidneys are functioning better.

This was a four-year, small, randomized control trial with 41 participants. The control group’s diet included 70 percent animal protein and 30 percent vegetable protein, while the treatment group’s diet consisted of 35 percent animal protein, 35 percent textured soy protein and 30 percent vegetable protein.

This is important, since diabetes patients are 20 to 40 times more likely to develop nephropathy than those without diabetes (7). It appears that soy protein may put substantially less stress on the kidneys than animal protein. However, those who have hypothyroidism and low iodine levels should be cautious about soy consumption; some studies suggest it might interfere with synthetic thyroid medications’ effectiveness (8).

Myth: Ozempic/Mounjaro helps with weight loss

One of the latest entrants in diabetes sugar-control/weight loss pursuit is GLP-1 receptor agonists, including tirzepatide (Mounjaro/Zepbound) and semaglutide (Ozempic/Wegovy). They have a primary focus on glucose control and a secondary effect of weight loss. It sounds like a dream, right? Unfortunately, it’s not that simple. It’s important to recognize that the phase III clinical trial of these drugs’ weight loss capabilities actually excluded patients with diabetes (9). While the trials did measure lean body mass at different points and doses, they did not report muscle loss.

In clinical use since their approval, further studies have found patients can lose significant muscle mass during treatment. Quoted numbers range between 10 and 25 percent muscle loss (10, 11). In my practice, I have seen an average of 50 percent muscle loss. Because of this tendency, those taking tirzepatide and semaglutide need to make lifestyle changes to offset this, including weight training and diet.

We still have a lot to learn with diabetes, but our understanding of how to manage lifestyle modifications is becoming clearer. Emphasizing a plant-based diet focused on whole fruits, vegetables, beans and legumes can improve your outcomes. 

If you choose a medical approach, you still need to make significant lifestyle changes to overcome its risks.

References: 

(1) Nutr J. 2013 Mar. 5;12:29. (2) Am J Clin Nutr. 2012 Apr.;95:925-933. (3) BMJ online 2013 Aug. 29. (4) Diabetes Care. online 2014 Feb. 18. (5) Br J Nutr. 2005;93:393–402. (6) Diabetes Care. 2008;31:648-654. (7) N Engl J Med. 1993;328:1676–1685. (8) Thyroid. 2006 Mar;16(3):249-58. (9) N Engl J Med 2022;387:205-216. (10) AACE Clin Case Reports. 2025 Mar-Apr.;11(2):98-101. (11) Diabetes, Obesity and Metabolism. 2025 May. 27(5): 2720-2729.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management.

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Ellen Pikitch as a delegate for Monaco at the United Nations in April.

By Daniel Dunaief

To borrow from the show Hamilton, Ellen Pikitch was in the room where it happens.

The Endowed Professor of Ocean Conservation Science at Stony Brook University, Pikitch traveled to the United Nations on the east side of Manhattan last month to serve as a delegate for Monaco during the Preparatory Commission for the High Seas Treaty, which is also known as Biodiversity Beyond National Jurisdiction.

The meeting, the first of several gatherings scheduled after the passage of the historic High Seas Treaty that is designed to protect 30 percent of the oceans by 2030, started to create a framework of rules and procedures.

Pikitch, who has advanced, developed and implemented Marine Protected Areas globally, was pleased with the early progress.

“I came away feeling optimistic that we are going to have a functional High Seas Treaty within a couple of years,” said Pikitch. “These details are being hashed out before the treaty comes into force.”

Indeed, 60 nations need to ratify the treaty for it to come into force.

At this point, 20 of the 194 countries that are member state of the United Nations have ratified the treaty. Each country has its own procedures for providing national support for an effort designed to protect biodiversity and natural resources.

Numerous representatives and members of environmental organizations are encouraging leaders of countries to ratify the treaty before the United Nations Oceans conference in Nice from June 9th to June 13th.

Award winning actress and activist Jane Fonda gave a speech at the meeting, urging countries to take the next steps.

“This isn’t just about protecting the oceans. It’s about protecting ourselves,” said Fonda. “Please, please, when you go back to your capitals in the next few days, remind your ministers of what we’re working toward. Remind them that we have a chance this year to change the future.”

Getting 60 ratifications this year is going to be “another monumental achievement,” Fonda continued. “We know it isn’t easy, but we also know that without the level of urgency… the target of protecting 30 percent of the world’s oceans will slip out of our grasp.”

Pikitch expects that the first 60 countries will be the hardest and that, once those agree, others will likely want to join to make sure they are part of the decision making. The treaty will form a framework or benefit sharing from biodiversity discovered as well as the resource use and extraction at these high seas sites.

“New discoveries from the high seas are too important for countries to ignore,” Pikitch said.

The members who ratify the treaty will work on a framework for designating protected areas on the high seas.

Pikitch shared Fonda’s sense of urgency in advancing the treaty and protecting the oceans.

“There is no time to waste,” Pikitch said. In the Stony Brook Professor’s opinion, the hardest part of the work has already occurred, with the long-awaited signing of the treaty. Still, she said it “can’t take another 20 years for the High Seas Treaty to come into effect.”

Monaco connection

Pikitch has had a connection with the small nation of Monaco, which borders on the southeastern coast of France and borders on the Mediterranean Sea, for over a decade.

Isabelle Picco, the Permanent Representative to the United Nations for Monaco, asked Pikitch to serve as one of the two delegates at the preparatory commission last month.

Pikitch is “thrilled” to be working with Monaco and hopes to contribute in a meaningful way to the discussion and planning for the nuts and bolts of the treaty.

Other meetings are scheduled for August and for early next year.

Most provisions at the United Nations require unanimous agreement, which, in part, is why the treaty itself took over 20 years. Any country could have held up the process of agreeing to the treaty.

To approve of a marine protected area, the group would only need a 2/3 vote, not a complete consensus. That, Pikitch hopes, would make it more likely to create a greater number of these protected places.

Scientific committee

The meeting involved discussions over how the treaty would work. Once the treaty has come into force, a scientific committee will advise the secretariat. The group addressed numerous issues related to this committee, such as the number of its members, a general framework for how members would be selected, the composition of the committee in terms of geographic representation, how often the committee would meet and whether the committee could set up working groups for topics that might arise.

Representatives of many countries expressed support for the notion that the scientific committee would make decisions based on their expertise, rather than as representatives of their government. This approach could make science the driving force behind the recommendations, rather than politics, enabling participants to use their judgement rather than echo a political party line for the party in power from their country.

Several participants also endorsed the idea that at least one indigenous scientist should be on this committee.

Pikitch, who has also served at the UN as a representative for the country of Palau, was pleased that the meeting had considerable agreement.

“There was a spirit of cooperation and a willingness to move forward with something important,” she said. By participating in a timely and meaningful way in this process, [the countries involved] are behaving as though they are convinced a high seas treaty will come into force” before too long.

Ultimately, Pikitch expects that the agreement will be a living, breathing treaty, which will give it the flexibility to respond to fluid situations.

As Fonda suggested, the treaty is about “recognizing that the fate of humanity is inextricably linked to the health of the natural world.” She thanked the group for “giving me hope.”

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