Columns

Members of the quantum materials team, from left, Gregory Doerk, Jerzy Sadowski, Kevin Yager, Young Jae Shin and Aaron Stein. Photo from BNL

By Daniel Dunaief

Henry Ford revolutionized the way people manufactured cars through automation, speeding up the process, reducing waste and cutting costs.

Similarly, at Brookhaven National Laboratory, researchers like the newly hired Young Jae Shin, who is a staff scientist at the Center for Functional Nanomaterials, hopes to improve the process of automating the handling of thin flakes of material used in a next generation technology called quantum information science, or QIS.

Working with scientists at Harvard University and the Massachusetts Institute of Technology, Shin is looking for ways to handle these flakes, which are one atom thick, of two-dimensional layers from different materials. Stacked together, these flakes can help create structures with specific electronic, magnetic or optical properties that can be used as sensors, in communication, or encryption.

Young Jae Shin at Harvard University, where he was a post doctoral researcher. Photo from Y. Shin

“Researchers are building these kinds of customized structures manually now,” explained Kevin Yager, leader of the CFN Electronic Nanomaterials Group, in an email. “QPress [Quantum Material Press] will allow us to automate this.” At this point, QPress is just starting, but, if it works, it will “absolutely allow us to accelerate the study of these materials, allowing researchers to find optimal materials quickly,” Yager continued.

Theoretically, quantum computers overcome the limitations of other systems, Shin explained.

The flakes come from the exfoliation of thin structures taken from a bulk material. This is akin to a collection of leaves that fall around trees. According to Yager, the structures scientists hope to make would be akin to a collection of leaves from different trees, put together to make a new structure or material with specific properties. “The idea is for the robot to sift through the flakes, and identify the ‘best’ ones and to stack these together into the right structure. The ‘stacking’ will involve combining flakes of different materials,” he said.

The less desirable flakes typically are the wrong size, have tears, ripples or other defects and have contaminants. Groups of scientists are predicting the kinds of layered designs that will have desired properties.

Shin suggested that the CFN supports the needs of the end user community, as CFN is a “user-based facility.”

Physicists at Harvard and MIT plan to use the QPress to study unusual forms of superconductivity. By tapping into materials that conduct electricity without losing energy at lower temperatures, researchers may make progress in quantum computing, which could exceed the ability of the current state-of-the-art supercomputers.

Stacking the flakes can create new materials whose properties not only depend on the individual layers, but also on the angle between the stacks. Scientists can change one of these new structures from having metallic to having insulating properties, just by altering the relative angle of the atoms. The challenge, however, is that putting these fine layers together by hand takes time and generates errors which, BNL hopes, an automated approach can help reduce.

“Ultimately, we would like to develop a robot that delivers a stacked structure based on the 2-D flake sequences and crystal orientations that scientists select through a web interface” to a machine, Charles Black, the head of the Center for Functional Nanomaterials at BNL, explained in a recent BNL feature. “If successful, the QPress would enable scientists to spend their time and energy studying materials, rather than making them.”

Barring unforeseen delays, scientists anticipate that they will be able to build a machine that creates these flakes, catalogs them, stacks them and characterizes their properties within three years. These functions will be available online in stages, to allow the use of the QPress prior to its completion.

Each stage in the QPress process uses computer software to reduce the effort involved in generating and interpreting usable structures.

Minh Hoai Nguyen, an assistant professor in the Department of Computer Science at Stony Brook University and doctoral student Boyu Wang from the Computer Vision Lab at SBU are creating a flake cataloger, which will use image analysis software to scan and record the location of flakes and their properties.

“The flakes that scientists are interested in are thin and thus faint, so manual and visual inspection is a laborious and error-prone process,” Nguyen said in the BNL feature.

At BNL, Shin is one of three scientists the Upton-based facility is hiring as a part of this effort. They are also seeking robot or imaging process experts. Shin has “been in the CFN just a short while, but is already having an impact- — for instance, allowing us to handle classes of two-dimensional materials that we were not working with before,” Yager said.

The field of quantum information science is extremely competitive, with researchers from all over the world seeking ways to benefit from the properties of materials on such a small scale. The United States has been investing in this field to develop leadership science in this area.

The University of Tokyo has developed an automation system, but Shin explained that it is still not perfect.

Yager said that numerous unknown applications are “waiting to be discovered. Researchers are working hard on real quantum computers. Prototypes already exist but creating viable large-scale quantum computers is a major challenge.”

A resident of on-site housing at BNL, Shin was born in the United States and grew up in Korea. He is married to Hyo Jung Kim, who is studying violin at Boston University. 

As for the work Shin and others are doing, Yager suggested that the effort has generated considerable interest at the CFN.

“There is huge excitement at BNL about quantum research broadly and QPress in particular,” said Yager. Shin is “a big part of this — bringing new technical knowledge and new enthusiasm to this ambitious project.”

Stock photo
Improving RHR can improve your healthy life span 

By David Dunaief, M.D.

Dr. David Dunaief

What does our heart rate, or pulse, tell us beyond the obvious fact that we are alive?

Our “normal” resting heart rate is between 60 to 100 beats per minute (bpm). A resting heart rate (RHR) above 100 bpm is referred to as tachycardia, or a racing heartbeat, and it has potentially serious consequences. 

However, even normal RHRs can be stratified to identify risks for diseases. What I mean is that, even in the normal range, as your resting heart rate increases, so do your potential risks. Actually, resting heart rate below approximately 70 bpm may be ideal.

Resting heart rate’s importance should not be underestimated. In fact, it may play a role in longevity, heart disease — including heart failure, arrhythmias, heart attacks and sudden cardiac death — and even chronic kidney disease. The good news is that RHR is modifiable. Methods that may reduce your rate include medications for high blood pressure, such as beta blockers, and lifestyle modifications, including meditation, dietary changes and exercise.

Impact on life span

Reducing RHR may be an important component in living a longer, healthier lifestyle. In the Copenhagen Male Study, a prospective study that followed 2,798 participants for 16 years, results showed that those with higher resting heart rates had a greater risk of death (1). There was a linear relationship between the risk of death and increasing RHR. Those who had a resting heart rate above 90 bpm were at a threefold greater risk of death, compared to those who had a RHR at or below 50 bpm. RHR was inversely related to the amount of physical activity.

Thus, the authors concluded that a “healthy” person with higher RHR may still have a shorter life span, with all other factors being equal, such as physical activity and blood pressure.

In contrast with the previous study, the following one took a “glass is half-full” approach to longevity. The Jerusalem Longitudinal Cohort Study showed that elderly women and men who had a lower RHR lived the longest (2). There were more than 2,000 study participants, ranging from 70 to 90 years old.

Your resting heart rate can help identify
potential health problems as well as gauge your current heart health.
Stock photo

Heart disease mortality

In the Nord-Trondelag Health Study, a prospective observational study, those who had a higher RHR at the end of the study than they did at the beginning of the study 10 years prior were more likely to die from heart disease (3). In other words, as the RHR increased from less than 70 bpm to over 85 bpm, there was a 90 percent greater risk of heart disease, compared to those who maintained a RHR of less than 70 throughout the two measurements. This study involved 30,000 participants who were healthy volunteers at least 20 years old.

Heart attacks

In the Women’s Health Initiative, results showed a 26 percent decrease in the risk of cardiovascular events in those postmenopausal women who had a RHR below 62 bpm, compared to those who had a RHR above 76 bpm (4). Interestingly, these results were even more substantial in the subgroup of women who were newly postmenopausal, ranging in age from 50 to 64.

Effect on kidney function

I have written many times about chronic kidney disease. An interesting follow-up is resting heart rate and its impact on kidney function. In the Atherosclerosis Risk in Communities Study, results showed that the most severe form of chronic kidney disease, end-stage renal disease, was 98 percent more likely to occur in those with the highest RHR, compared to those with the lowest (5). There were approximately 13,000 participants in the study, with a 16-year follow-up. The authors hypothesized that this negative effect on the kidney may be due to a loss of homeostasis in the autonomic (involuntary) nervous system, resulting in blood vessel dysfunction, such as increased inflammation and vasoconstriction (narrowing).

Can RHR be too low?

Is there a resting heart rate that is too low? Well, it depends on the context. If you are a marathoner or an athlete, then a RHR in the 40s may not be abnormal. For a healthy, physically active individual, it is not uncommon to have a resting heart rate in the 50s. However, if you are on medications that reduce your RHR and/or have a chronic disease, such as heart failure, it is probably not advisable to go much below 60 bpm. Always ask your doctor about the appropriate resting heart rate for your particular situation.

Thus, resting heart rate is an easy and inexpensive biomarker to potentially determine risk stratification for disease and to increase longevity, even for those in the normal range. By monitoring and modifying RHR, we can use it as a tool for primary disease prevention. 

References:

(1) Heart Journal 2013 Jun;99(12):882-887. (2) J Am Geriatr Soc. 2013;61(1):40-45. (3) JAMA 2011; 306:2579-2587. (4) BMJ. 2009 Feb 3;338:b219. (5) J Am Soc Nephrol. 2010 Sept;21(9):1560-1570.

Dr. 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. 

٭We invite you to check out our weekly Medical Compass MD Health Videos on                                        Times Beacon Record News Media’s website, www.tbrnewsmedia.com.٭

Foil-Wrapped Scampi and Linguini

By Barbara Beltrami

Except for a carefully manicured lawn or oversized SUV, I think there is nothing as emblematic of suburbia as the outdoor grill. However, in these days of more conscientious and healthful eating habits it is likely to conjure up an image rather different from that of former times. Then, Dad, garbed in a chef’s toque, oversized potholder mitt and motto-inscribed apron, stood in a cloud of black smoke flipping hamburgers, spearing hot dogs and slathering ribs and chicken with viscous crimson sauces. 

These days the grill still signifies suburbia, but the fare is just as likely to be fish, shellfish or veggies doused with marinades of oils, vinegars, juices and herbs or rubbed with spices, and it’s just as likely to be Mom wielding those tongs or spatula. The weather is warmer, spring is here and summer is just around the corner, so uncover that grill and get going!

Margarita-Marinated Grilled Swordfish

YIELD: Makes 4 servings

 INGREDIENTS:

2 pounds swordfish, cut into 4 pieces

1/3 cup freshly squeezed lime juice

¼ cup tequila

3 tablespoons olive oil

1 teaspoon ground cumin

¼ cup chopped onion

Sea salt and freshly ground pepper to taste

1 lime, quartered

2 handfuls fresh cilantro leaves, chopped

DIRECTIONS:

Rinse swordfish steaks and pat dry. In a shallow nonreactive dish combine lime juice, tequila, oil, cumin, onion, salt and pepper; add swordfish, sprinkle with half the cilantro, cover, refrigerate and allow to marinate for 30 minutes. Turn, cover and marinate 30 minutes more. At midpoint in marinating process, prepare the grill and preheat on medium. After the hour of marinating, place fish on grill and cook, gently turning once, 3 to 7 minutes on each side, depending on its thickness; baste with leftover marinade. Remove from grill, garnish with fresh lime wedges and remaining cilantro; serve hot or warm with a bean salad.

Foil-Wrapped Scampi and Linguini

Foil-Wrapped Scampi and Linguini

YIELD: Makes 4 servings

 INGREDIENTS:

2 pounds large shrimp, peeled and deveined

¾ stick unsalted butter, cut into chunks

2 tablespoons dry white wine

4 garlic cloves, peeled and sliced

Juice and zest of half a lemon

1 teaspoon dried hot red pepper flakes

½ cup chopped fresh flat-leaf parsley

½ cup chopped fresh basil leaves

Sea salt and freshly ground pepper to taste

1 pound linguini

DIRECTIONS:

Prepare grill on high heat. Tear off two pieces of 18-inch-long foil; lay on top of each other. In a medium bowl, combine all ingredients; transfer to center of foil; fold long ends of foil over each other to create a seal, then bring short ends up and fold tightly to ensure that the packet is completely sealed. Let sit while you bring a pot of water to boil for pasta. Cook pasta according to package directions; while pasta is cooking, place foil packet on grill. Each should take about 8 to 10 minutes; pasta is done when al dente; shrimp is done when completely pink. Place pasta in a large serving bowl; open packet carefully to let steam escape and empty contents over pasta. Toss and serve immediately with a crisp green salad and dry white wine.

Grilled Potatoes and Vidalia Onions

YIELD: Makes 4 to 6 servings

 INGREDIENTS:

1/3 cup olive oil

Coarse salt and freshly ground black pepper to taste

6 large potatoes, scrubbed and cut into ½-inch-thick slices

4 Vidalia onions, peeled and cut into ¾-inch-thick slices

DIRECTIONS:

Preheat grill to medium-high. Meanwhile, in a small bowl, combine olive oil and salt and pepper and with a pastry brush, coat both sides of potato and onion slices with mixture; place on grill and turning once when bottoms of slices are dark brown, grill until fork tender, about 15 minutes. Serve hot or warm with grilled fish, shellfish, meat or fowl.

MEET PATTI!

This week’s featured shelter pet is Patti, a 1 1/2 year old domestic short haired cat with soft black hair and stunning yellow eyes. Patti has a quiet disposition but loves to play with toys and is also great with children. She comes spayed, microchipped and up to date on all her vaccines. All this sweetheart needs now is a loving home.

Kent Animal Shelter is located at 2259 River Road in Calverton. The adoption center is open seven days a week from 10 a.m. to 4 p.m. For more information on Patti and other adoptable pets at Kent, call 631-727-5731 or visit www.kentanimalshelter.com.

PRETTY BIRD

Gerard Romano of Port Jefferson Station was walking along Van Brunt Manor road in Poquott on April 22 when this great egret popped its head out of the reeds. He writes, ‘I am not a wildlife photographer, but I gave this bird a go with my new Nikon 70-300mm lens. He was very elusive, but I managed to capture a photo of his pretty face.’

By Bob Lipinski

Bob Lipinski

Franciacorta is a “classic method” sparkling wine made in the province of Brescia in Italy’s northern region of Lombardy. According to its DOCG (1995) regulations, Franciacorta can be made into a white or rosé sparkling wine, which can range from demisec (semisweet) all the way to extra brut (extremely dry).

Franciacorta is Italy’s highest-quality sparkling wine and is made using the same production method as champagne using pinot noir and chardonnay grapes. Aging requirements for Franciacorta are longer than champagne and most sell at a lower price.

While pinot noir is the only red grape permitted, white grape varieties include chardonnay, pinot bianco and erbamat (a local specialty). 

Franciacorta made with lower pressure in a brut style from chardonnay and pinot bianco grapes is called Satèn. A millesimato (vintage-dated) and riserva (aged over 5 years) styles are authorized.

Some recommended Franciacorta wines are:

2012 Monte Rossa “Cabochon” Brut (70% chardonnay/30% pinot noir). Full celery-apple bouquet; citrus notes along with bread dough; full-bodied, rich fruit flavored.

2014 Monogram, Castel Faglia “Dosage Zero” Millesimato (90% chardonnay/10% pinot noir). Bread toast bouquet with hints of green apple and celery. Medium-full bodied; melon, pear and citrus flavors.

2011 Corte Bianca, “Rosé” (100% pinot noir aged 3 years). Full berry nose; clean and crisp with flavors of cherry, cranberry, rhubarb, and raspberry. Full-bodied and full of flavor.

NV Ca’ del Bosco “Cuvée Prestige” (75% chardonnay/15% pinot noir/10% pinot bianco). Crisp, delicate bouquet; creamy in the mouth; hints of dried flowers, Bosc pears and Granny Smith apples.

2012 Bellavista Brut Millesimato (63% chardonnay/27% pinot noir). Straw-colored; pinpoint bubbles; bouquet of almonds, dried fruit and pears. Delicate with a strong, elegant aftertaste.

NV Cavalleri “Blanc de Blancs,” Brut (100% chardonnay). Apple and pear bouquet with hints of biscuits, celery and hazelnuts; well-balanced and quite dry with a long aftertaste.

NV Guido Berlucchi Rosé (60% pinot noir/40% chardonnay). Very fruity bouquet; plenty of pinot noir berries; good structure; balanced with an aftertaste of cranberries.

NV Majolini “Blanc de Noirs” Brut (100% pinot noir). Hint of color with a full fruity bouquet of strawberries and rhubarb. Hints of candy apple, black figs and wheat.

Cheese and sparkling wines are an extra special indulgence we need to enjoy more often. Some of my favorite cheeses to nibble on while sipping a “glass of bubbly” are Boursin, brie, blue cheese, Excelsior, Gruyere, manchego, Monterey Jack and Parmigiano-Reggiano.

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].

From left, Megan Crow, Associate Professor Jesse Gillis and postdoctoral researcher Sara Ballouz Photo by Gina Motisi/CSHL

By Daniel Dunaief

Diversity has become a buzz word in the workplace, as companies look to bring different perspectives that might represent customers, constituents or business partners. The same holds true for the human brain, which contains a wide assortment of interneurons that have numerous shapes and functions.

Interneurons act like a negative signal or a brake, slowing or stopping the transmission. Like a negative sign in math, though, some interneurons put the brakes on other neurons, performing a double negative role of disinhibiting. These cells of the nervous system, which are in places including the brain, spinal chord and retina, allow for the orderly and coordinated flow of signals.

One of the challenges in the study of these important cells is that scientists can’t agree on the number of types of interneurons.

“In classifying interneurons, everyone argues about them,” said Megan Crow, a postdoctoral researcher in Jesse Gillis’ lab at Cold Spring Harbor Laboratory. “People come to this question with many different techniques, whether they are looking at the shape or the connectivity or the electrophysiological properties.”

Megan Crow. Photo by Constance Brukin

Crow recently received a two-year grant from the National Institutes of Health to try to measure and explain the diversity of interneurons that, down the road, could have implications for neurological diseases or disorders in which an excitatory stimulus lasts too long.

“Understanding interneuron diversity is one of the holy grails of neuroscience,” explained Gillis in an email. “It is central to the broader mission of understanding the neural circuits which underlie all behavior.”

Crow plans to use molecular classifications to understand these subtypes of neurons. Her “specific vision” involves exploiting “expected relationships between genes and across data modalities in a biologically thoughtful way,” said Gillis.

Crow’s earlier research suggests there are 11 subtypes in the mouse brain, but the exact number is a “work in progress,” she said.

Her work studying the interneurons of the neocortex has been “some of the most influential work in our field in the last two to three years,” said Shreejoy Tripathy, an assistant professor in the Department of Psychiatry at the University of Toronto. Tripathy hasn’t collaborated with Crow but has been aware of her work for several years.

The interactivity of a neuron is akin to personalities people demonstrate when they are in a social setting. The goal of a neuronal circuit is to take an input and turn it into an output. Interneurons are at the center of this circuit, and their “personalities” affect the way they influence information flow, Crow suggested.

“If you think of a neuron as a person, there are main personality characteristics,” she explained. Some neurons are the equivalent of extraverted, which suggests that they have a lot of adhesion proteins that will make connections with other cells.

“The way neurons speak to one another is important in determining” their classes or types, she said.

A major advance that enabled this analysis springs from new technology, including single-cell RNA sequencing, which allows scientists to make thousands of measurements from thousands of cells, all at the same time.

“What I specialize in and what gives us a big leg up is that we can compare all of the outputs from all of the labs,” Crow said. She is no longer conducting her own research to produce data and, instead, is putting together the enormous volume of information that comes out of labs around the world.

Megan Crow. Photo by Daniel Katt

Using data from other scientists does introduce an element of variability, but Crow believes she is more of a “lumper than a splitter,” although she would like to try to understand variation where it is statistically possible.

She believes in using data for which she has rigorous quality control, adding, “If we know some research has been validated externally more rigorously than others, we might tend to trust those classifications with more confidence.”

Additionally she plans to collaborate with Josh Huang, the Charles Robertson professor of neuroscience at Cold Spring Harbor Laboratory, who she described as an interneuron expert and suggested she would use his expertise as a “sniff test” on certain experiments.

At this point, Crow is in the process of collecting baseline data. Eventually, she recognizes that some interneurons might change in their role from one group to another, depending on the stimuli.,

Crow hasn’t always pursued a computational approach to research. 

In her graduate work at King’s College London, she produced data and analyzed her own experiments, studying the sensory experience of pain.

One of the challenges scientists are addressing is how pain becomes chronic, like an injury that never heals. The opioid crisis is a problem for numerous reasons, including that people are in chronic pain. Crow was interested in understanding the neurons involved in pain, and to figure out a way to treat it. “The sensory neurons in pain sparked my general interest in how neurons work and what makes them into what they are,” she said.

Crow indicated that two things brought her to the pain field. For starters, she had a fantastic undergraduate mentor at McGill University, Professor of Psychology Jeff Mogil, who “brought the field to life for me by explaining its socio-economic importance, its evolutionary ancient origins, and showed me how mouse behavioral genetic approaches could make inroads into a largely intractable problem.”

Crow also said she had a feeling that there might be room to make an impact on the field by focusing on molecular genetic techniques rather than the more traditional electrophysiological and pharmacological approaches.

As for computational biology, she said she focuses on interpreting data, rather than in other areas of the field, which include building models and simulations or developing algorithms and software.

In the bigger picture, Crow said she’s still very interested in disease and would like to understand the role that interneurons and other cells play. “If we can get the tools to be able to target” some of the cells involved in diseases, “we might find away to treat those conditions.”

The kind of research she is conducting could start to provide an understanding of how cells interact and what can go wrong in their neurodevelopment.

Gillis praises his postdoctoral researcher for the impact of her research.

“Just about any time [Crow] has presented her work — and she has done it a lot — she has ended up convincing members of the audience so strongly that they either want to collaborate, adapt her ideas, or recruit her,” Gillis wrote in an email. 

Crow grew up in Toronto, Canada. She said she loved school, including science and math, but she also enjoyed reading and performing in school plays. She directed a play and was in “The Merchant of Venice.” In high school, she also used to teach skiing.

A resident of Park Slope in Brooklyn, Crow commutes about an hour each way on the train, during which she can do some work and catch up on her reading.

She appreciates the opportunity to work with other researchers at Cold Spring Harbor, which has been “an incredible learning experience.”

By Nancy Burner, Esq.

Nancy Burner, Esq.

The best way to manage your own affairs while you are alive and to provide properly for your beneficiaries at your death is to have an estate plan. There is a distinction between having a “plan” and having documents. The close attention to detail, knowledge of the law and past experiences of the attorney you are dealing with should help you create the plan that fits your own circumstances.

The first step of the process is to gather a comprehensive list of your assets. Since everything in the plan is different depending on the personal circumstances, it is important for the attorney advising you to know what type of assets you have and in what quantity. An individual with a home worth $400,000 may require a very different plan than an individual with the same amount of assets that are held in cash or retirement accounts. 

Once you have your list of assets together, you can review it with the attorney and discuss the goals of the representation. For many clients, the primary goal is to make sure they are taken care of during their own lifetime with the maximum amount of control over their assets without concern for what happens upon their death, while others may have concern for those they wish to benefit at their death.  

Take the single mother with a disabled child; while she is concerned about her own well-being, she would likely consider the well-being of her child to be equally as important. By contrast, a single person with no children will have different concerns and, therefore, a different estate plan. 

Discussing your goals with an attorney is the greatest value the attorney can provide. Estate planning attorneys are more than just document drafters. They are advisers. With your attorney, you should be running through the different scenarios that may occur at the time of your death and making sure that you are satisfied with the outcome of each based on the plan you decide to create. 

The estate planning attorney can flag for you other issues that may be of concern. Depending on your age, income and assets, it may be prudent to discuss long-term care insurance or asset protection planning for Medicaid purposes. You can discuss whether or not your beneficiaries will need a trust for any reason, including creditor protection, protection of government benefits or protection from themselves if they overspend and undersave. 

After you have discussed your assets and goals with the attorney, they can recommend options for you. Often, there is more than one option available. A description of the pros and cons of each plan and the cost to you should help you determine what is best in your circumstance. This is the point at which the documents can be created in draft form. If you are satisfied with the documents as written, they will then be signed with the attorney. Each document will have its own signing requirements for validity that will include the presence of witnesses and/or a notary public.  

If you have never created an estate plan or have not reviewed it in the last five years, you should reach out to an attorney to start the process.  

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.

By David Dunaief, M.D.

Dr. David Dunaief

Obesity is continuously covered in the media. And rightly so. Its economic cost to the U.S. is massive: in 2016, the cost of chronic diseases for which being obese or overweight is a risk factor totaled over $480 billion in direct health care costs and $1.24 trillion in lost economic productivity (1). These startling numbers don’t even consider the human cost of these diseases.

Obesity and its effect on life span

It’s well-known that obesity could have an impact on development of other chronic diseases and decrease quality of life, but to what extent? A 2013 study indicated that almost as many as one in five deaths in the U.S. is associated with obesity (2).

In a computer modeling study, results showed that those who are obese may lose up to eight years, almost a decade, of their life span (3). But that is only part of the picture. The other, more compelling result is that patients who are very obese, defined as a BMI >35 kg/m², could lose almost two decades of healthy living. According to the researchers, this means you may have diseases such as diabetes and cardiovascular disease. However, even those patients who were obese and those who were overweight could have reductions in life span, up to six years and three years, respectively.

This study evaluated 3,992 adults between the ages of 20 and 79. The data was taken from an NHANES database from 2003 to 2010, which looked at participants who went on to develop diabetes and cardiovascular disease. Though this is not a clinical trial, and there is a need for more study, the results are eye-opening, with the youngest and very obese negatively impacted the most.

Cancer impact

Since it is very difficult to “cure” cancer, it is important to reduce modifiable risk factors. Obesity may be one of these contributing factors, although it is hotly debatable how much of an impact obesity has on cancer development.  The American Society of Clinical Oncologists (ASCO), in a position paper, supported the idea that it is important to treat obesity in the fight against cancer (4). The authors indicate obesity may make the prognosis worse, may hinder the delivery of therapies to treat cancer, and may increase the risk of malignancy.

Also, possibly reinforcing ASCO’s stance, a study suggested that upward of a half-million cases of cancer worldwide were related to being overweight or obese, with the overwhelming concentration in North America and Europe (5).

Possible solutions

A potential counterweight to both the reductions in life quality and life expectancy may be a Mediterranean-type diet. In a published analysis of the Nurses’ Health Study, results show that the Mediterranean diet helped slow shortening of the telomeres (6). Repeat sequences of DNA found at the end of chromosomes, telomeres, shorten with age; the shorter the telomere, the shorter life expectancy.

Thus, the Mediterranean-type diet may decrease occurrence of chronic diseases, increase life span and decrease premature mortality — countering the effects of obesity. In fact, it may help treat obesity, though this was not mentioned in the study. Interestingly, the greater the adherence to the diet, rated on a scale of 0 to 9, the better the effect. Those who had an increase in adherence by three points saw a corresponding decrease in telomere aging by 4.5 years. There were 4,676 middle-aged women involved in this analysis. The researchers believe that the anti-inflammatory and antioxidant effects could be responsible for the diet’s effects.

According to an accompanying editorial, no individual component of the diet was identified as having beneficial effects by itself, so it may be the diet as a whole that is important (7).

Short-term solutions

There are easy-to-use distraction tactics that involve physical and mental techniques to reduce food cravings. These include tapping your foot on the floor, staring at a blank wall and alternating tapping your index finger against your forehead and your ear (8). The forehead and ear tapping technique was most effective, although probably most embarrassing in public. Among mental techniques, seeing pictures of foods that were unhealthy and focusing on their long-term detriments to health had the most impact (9). These short-term distractors were done for 30 seconds at a time. The results showed that they decreased food cravings in obese patients.

Exercise impact

I have written that exercise does not lead to fat percentage loss in adults. The results are different for adolescents, though. In a randomized controlled trial, results show that those in a resistance training group and those in a combined resistance and aerobic training group had significantly greater percentages of fat loss compared to a control group (10).

Interestingly, the aerobic group alone did not show a significant change in fat percent versus the control. There were 304 study participants, ages 14 to 18, followed for a six-month duration, and results were measured with MRI. The reason that resistance training was effective may have to do with an increase in muscle mass rather than a decrease in actual fat.

Obesity can have devastating effects, from potentially inducing cancer or worsening it, to shortening life expectancy and substantially decreasing quality of life. Fortunately, there may be ways to help treat obesity with specific lifestyle modifications. The Mediterranean diet as a whole may be an effective step toward decreasing the burden of obesity and reducing its complications. Kids, teenagers specifically, should be encouraged to do some resistance training. As we mentioned, there are simple techniques that may help reduce short-term food cravings.

References:

(1) “America’s Obesity Crisis,” Milken Institute. October, 2018. (2) Am J Public Health. 2013;103:1895-1901. (3) The Lancet Diabetes & Endocrinology, online Dec. 5, 2014. (4) J Clin Oncol. 2014;32(31):3568-3574. (5) The Lancet Oncology. online Nov. 26, 2014. (6) BMJ. online Dec. 2, 2014. (7) BMJ 2014;349:g6843. (8) Obesity Week 2014 abstract T-2658-P. (9) Obesity Week 2014 abstract T-3023-OR. (10) JAMA Pediatr. 2014;168(11):1006-1014.

Dr. 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.      

٭We invite you to check out our weekly Medical Compass MD Health Videos on Times Beacon Record News Media’s website, www.tbrnewsmedia.com.٭

The house on Lower Rocky Point Road in Sound Beach, a relatively quiet, two-lane road that parallels the North Shore coastline is somehow indicative of comfortable, suburban living. The house is quaint and the front yard is loaded with lawn ornaments. Now there’s something hauntingly disturbing at the sight of it.

On April 25, the Suffolk County district attorney announced a multicount indictment of a resident of that Sound Beach house, Raymond Rodio III, for allegedly keeping over 20 women in a cycle of drugs and prostitution over several years, often using that basement for activities related to that prostitution. The parents said they didn’t know. Comments from community members online were similarly flummoxed. Nobody expected a story like that to come from such a neighborhood.

Nobody ever does.

Everyone knows about the opioid epidemic. It’s said you don’t have to stick your arm out too far before you brush against someone who has been impacted by the crisis. For years it has ravaged Long Island, and only with concerted and multiyear efforts from community activists, journalists and policymakers are we finally starting to make efforts from the ground level up. Local legislators and school districts continually host Narcan training courses to aid overdose cases, and with the New York State budget, an expanded access to medication-assisted treatment has become available in both the hospital and jail settings.

Residents have commented online there are houses they suspect are involved in drug dealing, but why would anybody expect that this case also has allegedly been involved in human trafficking?

That’s just the thing — perhaps people need to be more alert to prevent these crimes.

Rodio was allegedly operating this illicit scheme for five years or maybe even longer. He got away with it for that long only until thankfully during an unrelated traffic stop an officer recognized that the woman passenger in Rodio’s car showed signs of being in a forced prostitution situation. 

Prostitution? On the North Shore? Yes, it does happen here, and it doesn’t just take place in seedy motels or in illicit massage parlor operations. It happens at reputable hotels, and online, through well-known websites like craigslist or on dating apps like Tinder. It’s likely that people as young as 15 years are involved. These sex traffickers often recruit online through social media or find young women with poor family lives or with existing drug problems.

It can happen anywhere. The case in Sound Beach more than proves it.

It’s time for parents and teachers to learn about this issue, one that has only grown with the opioid epidemic. Children need to learn the dangers beyond drugs, and adults should learn the warning signs to notice young women who might be involved in these truly horrific situations.

Many North Shore communities have continued to step up in the overwhelming face of the opioid crisis. We can take a stand against this issue as well.