CLOSE
Columns

by -
0 4486
Fruits and vegetables may protect the kidneys. Stock photo

By David Dunaief

Chronic kidney disease is on the rise in this country. In a study that looked at data from the National Health and Nutrition Examination Survey, prevalence of chronic kidney disease (CKD) increased more than 30 percent from 1988 to 2004 (1). Earlier-stage (moderate) CKD is no exception and may not be getting enough attention. In this article, we will look beyond the more obvious causes of moderate chronic kidney disease, like diabetes, smoking, aging, obesity and high blood pressure (2).

Why is earlier-stage CKD so important? It is associated with a 40 percent increased risk of developing cardiovascular events, such as heart attacks (3). It also significantly increases the risk of peripheral artery disease (PAD). Those with decreased kidney function have a 24 percent prevalence of PAD, compared to 3.7 percent in those with normal kidney function (4). Of course, it can lead ultimately to end-stage renal (kidney) disease, requiring dialysis and potentially a kidney transplant.

One of the problems with earlier-stage CKD is that it tends to be asymptomatic. However, there are simple tests, such as a basic metabolic panel and a urinalysis, that will indicate whether a patient may have moderate chronic kidney disease.

These indices for kidney function include an estimated glomerular filtration rate (eGFR), creatinine level and protein in the urine. While the other two indices have varying ranges depending on the laboratory used, a patient with an eGFR of 30 to 59 mL/minute/1.73 m2 is considered to have moderate disease. The eGFR and the kidney function are inversely related, meaning as eGFR declines, the more severe the chronic kidney disease.

What can be done to stem earlier-stage CKD, before complications occur? There are several studies that have looked at medications and lifestyle modifications and their impacts on its prevention, treatment and reversal. Let’s look at the evidence.

Medications

Allopurinol is usually thought of as a medication for the prevention of gout. However, in a randomized controlled trial, the gold standard of studies, the results show that allopurinol may help to slow the progression of CKD, defined in this study as an eGFR less than 60 mL/min/1.73 m2 (5).

The group using 100 mg of allopurinol showed significant improvement in eGFR levels (a 1.3 mL/minute per 1.73 m2 increase) compared to the control group (a 3.3 mL/minute per 1.73 m2 decrease) over a two-year period. There were 113 patients involved in this study. The researchers concluded that there was a slow progression of CKD with allopurinol. Allopurinol also decreased cardiovascular risk by 71 percent.

Fibrates are a class of drug usually used to boost HDL (“good”) cholesterol levels and reduce triglyceride levels, another cholesterol marker. Fibrates have gotten negative press for not showing improvement in cardiovascular outcomes.

However, in patients with moderate CKD, a meta-analysis (a group of 10 studies) showed a 30 percent reduction in major cardiovascular events and a 40 percent reduction in the risk of cardiovascular mortality with the use of fibrates (6). This is important, since patients with CKD are mostly likely to die of cardiovascular disease. The authors concluded that fibrates seem to have a much more powerful beneficial effect in CKD patients, as opposed to the general population. So, there may be a role for fibrates after all.

Lifestyle modifications

Fruits and vegetables may play a role in helping patients with CKD. In one study, the results showed that fruits and vegetables work as well as sodium bicarbonate in improving kidney function by reducing metabolic acidosis levels (7). What is the significance of metabolic acidosis? It means that body fluids become acidic and it is associated with chronic kidney disease. The authors concluded that both sodium bicarbonate and a diet including fruits and vegetables were renoprotective, helping to protect the kidneys from further damage in patients with CKD.

Alkali diets are primarily plant-based, although not necessarily vegetarian or vegan-based diets. Animal products tend to cause an acidic environment. The study was one year in duration. However, though the results were impressive, the study was small, with 77 patients.

Sodium rears its ugly head yet again. Red meat is not thought of positively, and animal fat is not far behind. In the Nurses’ Health Study, the results show that animal fat, red meat and salt all negatively impact kidney function (8). The risk of protein in the urine, a potential indicator of CKD, increased by 72 percent in those participants who consumed the highest amounts of animal fat compared to the lowest, and by 51 percent in those who ate red meat at least twice a week. With higher amounts of sodium, there was a 52 percent increased risk of having lower levels of eGFR.

The most interesting part with sodium was that the difference between higher mean consumption and the lower mean consumption was not that large, 2.4 grams compared to 1.7 grams. In other words, the difference between approximately a teaspoon of sodium and three quarters of a teaspoon was responsible for the decrease in kidney function.

In my practice, when CKD patients follow a vegetable-rich, nutrient-dense diet, there are substantial improvements in kidney functioning. For instance, for one patient, his baseline eGFR was 54 mL/min/1.73 m2. After one month of lifestyle modifications, his eGFR improved by 9 points to 63 mL/min/1.73 m2, which is a return to “normal” functioning of the kidney. His kidney functioning after 6 months actually exceeded 90 mL/min/1.73 m2 for eGFR. However, this is an anecdotal story and not a study.

Therefore, it is important to have your kidney function checked with mainstream tests. If the levels are low, you should address the issue through medications and/or lifestyle modifications to manage and reverse earlier-stage CKD. However, lifestyle modifications don’t have the negative side effects of medications. Don’t wait until symptoms and complications occur. In my experience, it is much easier to treat and reverse a disease in its earlier stages, and CKD is no exception.

References:

(1) JAMA. 2007;298:2038-2047. (2) JAMA. 2004;291:844-850. (3) N Engl J Med. 2004;351:1296-1305. (4) Circulation. 2004;109:320–323. (5) Clin J Am Soc Nephrol. 2010 Aug;5:1388-1393. (6) J Am Coll Cardiol. 2012 Nov. 13;60:2061-2071. (7) Clin J Am Soc Nephrol. 2013;8:371-381. (8) Clin J Am Soc Nephrol. 2010; 5:836-843.

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.

by -
0 81

Blast from the Past: Do you know when and where this photo was taken? What are these two men talking about? Email your answers to [email protected]. To see more wonderful vintage photographs like this, visit The Ward Melville Heritage Organization’s ongoing exhibit, It Takes a Team to Build a Village, at The WMHO’s Educational & Cultural Center, 97P Main Street, Stony Brook. For more information, call 631-751-2244.

Answer to last week’s Throwback Thursday:

Mr. and Mrs. Joseph L. Merrill of Locust Valley (foreground), and Mr. and Mrs. Ward Melville of Stony Brook share a box at the 67th National Horse Show at Madison Square Garden on November 1, 1955. Newsday/Tom Maguire

Mr. and Mrs. Joseph L. Merrill of Locust Valley (foreground), and Mr. and Mrs. Ward Melville of Stony Brook share a box at the 67th National Horse Show at Madison Square Garden on November 1, 1955.
Newsday/Tom Maguire

 

by -
0 2115
Dave Jackson. Photo courtesy of CSHL

By Daniel Dunaief

If we get a text message that our son just gained admission to his first choice for college, we might throw our arms in the air, pick up the phone and call him, or stand on the top of our desk and shout our joy to the room. We might feel, in that instant, as if he can achieve anything and, as a result, so can we.

While plants don’t send and receive text messages, they process and react to a range of signals, some of which can determine how and when they grow, which can be key parts of determining how much food they produce.

Recently, David Jackson, a professor at Cold Spring Harbor Laboratory, explored a mutation that causes corn, or maize, to experience growth that is so out-of-control that the corn becomes a disorganized mess. Jackson wondered what caused this growth and disrupted the creation of succulent rows of juicy, yellow bits ready to explode off the cob.

Stem cells can grow to become any type of cell. In this pathway, which was disrupted in the mutant and caused the uncontrolled growth, Jackson showed that the signal came from the leaves, which is likely responding to its surroundings. He discovered that fine tuning that mutation — or weakening the “grow-out-of-control” signal — was enough to cause a regular ear of corn to include as much as 50 percent more food. “What was surprising about our work is that we found this new stem cell pathway that had not been discovered in Arabidopsis,” which is, as Jackson described, considered the equivalent of the well-studied fruit fly in the plant world. “We had gone on to show that it was also present in Arabidopsis.”

At this point, he’s hoping to introduce these mutations or alleles into breeding lines to try to generate a similar increase in yields that he’s seen in the lab. He’s collaborating with DuPont Pioneer on that testing. “As in all areas of science, we make a basic discovery and hope it’ll be applicable,” he said. “We can’t guarantee it’ll work until” it’s checked in the field. “People cure cancer in mice, but find it’s more complicated in people. We’re hoping cumulative knowledge will lead to breakthroughs,” he added.

Sarah Hake, the director of the USDA Plant Gene Expression Center at the University of California at Berkeley, described the work as “important.” In an email, she suggested that “translation to more corn yield can take time, but this information will be crucial for thinking about breeding.”

Jackson received the mutated maize from a breeder in Russia. He then altered a wild type, or normal plant, to cause a similar mutation that produced more food. Jackson is excited about the potential to use the gene-altering technique called CRISPR, in which researchers can edit a genome, changing one or multiple base pairs at a time.

Above left, normal corn and, right, corn with a weakened Fea3 mutation. The mutated corn has up to 50 percent more yield. Photo by Byoung Il Je
Above left, normal corn and, right, corn with a weakened Fea3 mutation. The mutated corn has up to 50 percent more yield. Photo by Byoung Il Je

Jackson is not adding new genes but, rather, is “tweaking” the ones that are already there. He said agricultural companies can use CRISPR instead of dumping in a foreign DNA. In past experiments, Jackson has worked to produce a greater number of seeds in his experimental plants. In that work, however, he increased the number of seeds, although the size of the seeds was smaller, so the overall yield didn’t increase. In this study, however, he and his postdoctoral student Byoung Il Je produced more seeds that generated greater yield. The gene involved in this signaling pathway is called Fea3. It is part of the signaling network that tells the plant to pump more into the ear of the corn to produce more yield. Jackson named the gene Fea because of the way the corn looked. Fea stands for fasciated ear. He and the members of his lab had already characterized another gene, called Fea2.

Jackson has been working on this gene for 20 years, although the intensive work occurred more in the last four or five years. He said he’s benefited from the ability to take a mutant and identify the gene. When he started out 25 years ago, a graduate student could take five years to characterize a mutation and find a gene. “It was like looking for a needle in a haystack,” he said. Now, genome sequencing and fast mapping enables researchers to find a gene in as little as a few months. When he first produced the weaker mutation, Jackson wasn’t anticipating a higher yield but, rather, was hoping to prove that this gene was the one responsible for this uncontrolled growth that created a pulpy mess of corn. Jackson said he is “excited about the stem cell pathway” his lab discovered. He hopes this finding can lead to a better understanding of the signals that determine how a plant uses its resources.

A resident of Brooklyn, Jackson lives with his wife Kiyomi Tanigawa, an interior designer, and their eight-year-old son Toma.

Jackson, whose lab has seven postdoctoral researchers and one lab manager, plans to start experiments on tomatoes and rice to see how this gene is involved in similar signals in other food crops. He is also working on similar mutations to other genes like Fea3, which also might affect a plant’s decision to produce more food.

by -
0 64
The tree of heaven, a.k.a. the stink weed tree, has a bad odor. It’s also on the Do Not Sell list. Photo by Ellen Barcel

By Ellen Barcel

Many people think of gardening as outdoor work: mowing a lawn, fertilizing, watering, planting, pruning, etc. And while this is true, doing your homework, i.e., research, before you select plants will make life a whole lot easier for you.

Fall is an ideal planting time. For one thing, it’s cooler so you’ll use less supplemental water. For another, you are getting a jump start on next year’s gardening. It generally takes three growing seasons for a new plant to settle in and flourish. If you plant in fall, that counts as the first year, a year where it will be accustomed to its new home. Next spring it will grow a more extensive root structure; and the third season you’ll have a gorgeous, healthy plant.

But, remember, no plant is perfect. So, you need to know each plant’s pros and cons before you plant. Here are some examples:

Trees

Maple trees have an extensive root system near to the surface that can play havoc with your lawn. Norway maple also puts out a tremendous amount of seeds, meaning seedlings are everywhere. That means doing a lot of weeding. Yes, they’re on Suffolk’s Do Not Sell List, but friends or neighbors may offer you some. “No thank you” is the perfect reply.

Ginkgo trees (the female ones) produce a lot of foul smelling fruit. Most nurseries will sell only male trees, but, you really need to make sure. Unless you plan to use the fruit, as some Oriental cooks do, you really don’t want a female tree.

Sweet gum trees produce spiky seed pods that seem to land everywhere. While this is a lovely shade tree and the seed pods are really interesting to look at, do you want to spend time cleaning them up from lawns, walkways and anything else that is near them? If you want the sweet gum and have a large enough piece of property, plant it near the back of your garden, away from walkways, etc.

Black walnut trees have the reputation of killing many plants near them by putting out toxic (to the plants) chemicals. This is known as allelopathy. They’re beautiful shade trees, which produce great nuts for eating, but are you ready to deal with this problem?

The Bradford Pear is a beautiful tree with burgundy leaves in autumn but has a habit of splitting as a mature tree. Photo by Ellen Barcel
The Bradford Pear is a beautiful tree with burgundy leaves in autumn but has a habit of splitting as a mature tree. Photo by Ellen Barcel

Ornamental pear trees have the nasty habit of splitting or having large chunks of the tree break off as the tree matures and grows older. They’re fast growing trees, with lovely white flowers in spring and burgundy leaves in late fall. Yes, they’re beautiful trees, but you need to be aware of this potential problem.

Native dogwood (Cornus florida) can develop the fungal disease anthracnose, which can actually kill the tree while it only makes maples look ugly. So, if this is a concern, grow another variety of dogwood, such as Kousa dogwood (which blooms about a month or two later than C. florida).

Tree of heaven (Ailanthus altissima) is considered a weed. It seeds itself everywhere and has a foul smell — hence its nickname “stink weed tree.” This is also on the Do Not Sell List because of its invasive nature but easily found growing wild.

Weeping willow trees have a shallow root system and can easily be blown over in storms. I lost two that way and decided to replace them with other trees. Also note that willow wood doesn’t have a nice aroma used in a fireplace. So, if you lose the tree in a storm, you can’t even use the wood. The roots also have the reputation of heading for water sources, potentially damaging structures, so shouldn’t be planted by pools, etc.

The dawn redwood, once considered extinct, is a lovely coniferous tree. However, it has one quality that you may not like — it is deciduous. Yes, this is a unique specimen which loses its needles in the fall. If you are looking for coniferous trees to create a year round hedge or screen, then the dawn redwood is not for you. Next week: researching perennials and shrubs.

Ellen Barcel is a freelance writer and master gardener. To reach Cornell Cooperative Extension of Suffolk County and its Master Gardener program, call 631-727-7850.

by -
0 1173
Apple Brownies

Apple Brownies

Apple Brownies
Apple Brownies

INGREDIENTS:

1 stick salted butter, melted and cooled

1 cup flour

1 teaspoon cinnamon

1/2 teaspoon baking powder

1/2 teaspoon salt

1/4 teaspoon baking soda

3/4 cup sugar

1 large egg

1/2 cup chopped walnuts

2 large apples, peeled, cored and cut into 1/2-inch cubes (2 3/4 cups)

DIRECTIONS: Preheat oven to 350 F. Butter an 8- by 11-inch baking dish. Mix together flour, cinnamon, baking powder, salt and baking soda in a medium bowl. In a large bowl, beat together butter, sugar and egg for about 2 minutes. Add walnuts and apples. Stir by hand until mixed. Add flour mixture and mix. Spread batter in pan and bake for 40 minutes or until golden brown and slightly firm. Let cool for 30 minutes and cut into 12 bars before serving.

Baked Apples

Baked Apples
Baked Apples

INGREDIENTS:

4 large baking apples

4 tablespoons butter, softened

1/2 cup brown sugar

3/4 teaspoon cinnamon

1/4 cup chopped pecans

DIRECTIONS: Preheat the oven to 375 F. Wash and core apples, leaving enough of the core at the base of the apple to contain the filling. Combine the butter, brown sugar, cinnamon and chopped pecans in a small bowl. Roll log shapes of the mixture and press enough into each apple to fill the core. Fill a 2-quart baking dish with about 3/4 cup water, or enough to cover the bottom. Place the apples upright in the dish. Bake for one hour or until the apples are soft and the filling is browned.

Apple Cake

Apple Cake
Apple Cake

INGREDIENTS:

1/2 cup flour

2/3 cup sugar

1 tablespoon baking powder

1/8 teaspoon salt

1/3 cup milk

3 eggs

2 tablespoons oil

1/2 teaspoon vanilla extract

4 apples

3 tablespoons unsalted butter, melted

zest of one lemon

DIRECTIONS: Mix together flour, 1/3 cup sugar, baking powder and salt in a large bowl. In a medium bowl, combine milk, 2 eggs, oil and vanilla extract. Add to dry ingredients until combined (use a spoon or fork) Peel and slice apples (thin slices). Mix into batter. Pour batter into a 9-inch springform pan. Bake at 400 F. for 25 minutes until golden. Remove from oven. Leave the oven on at 400 F. Combine melted butter, 1 egg, 1/3 cup sugar and lemon zest. Pour over cake and bake cake for another 10 minutes. Loosen cake from pan sides while hot to prevent sticking. Cool and serve.

Apple Crisp

Apple Crisp
Apple Crisp

YIELD: Makes 4 to 6 servings

INGREDIENTS:

4 cups sliced and pared apples

1/4 cup orange juice

1/4 cup sugar

3/4 cup flour

1/2 teaspoon cinnamon

1/3 cup butter

DIRECTIONS: Mound apples in a buttered pie plate and pour orange juice over them. In a separate bowl, combine sugar, flour, and cinnamon. Cut in butter until mixture is crumbly. Sprinkle mixture over apples. Bake at 375 F for 45 minutes or until apples are tender and topping is crisp.

by -
0 1038

By Nancy Burner, ESQ.

It is not unusual for a client to contact me and ask to review their estate plan. This may be precipitated by a recent diagnosis or simply by the passage of time. I have a checklist that I use when reviewing an estate plan if they have a taxable estate. Under federal law, a taxable estate in 2016 is any estate over $5.45 million and in New York State any estate over $4,187,500.

• The annual gift tax exclusion is $14,000, which means the client can make annual gifts of $14,000 to any individual. The gift must be completed before the donor dies; therefore, the check must not only be delivered but also cashed before the donor’s death. High basis assets such as cash are excellent lifetime gifts. The donee takes the tax basis of the lifetime gifted asset; but assets in the estate receive a “step-up” in basis. Therefore, it is best to leave the highly appreciated real estate or Apple stock in the estate.

• The client could also pay any medical or educational expenses for any individual. The payments must be made directly to the institution or the medical provider. The college or university will even allow the tuition to be prepaid for the entire four years. The payment must be irrevocable and made to a qualified educational organization.

• It may also be prudent to make taxable gifts before the client dies if the estate exceeds the federal gift tax exemption amount. While the gift tax on lifetime gifts is 40 percent and the estate tax is also 40 percent, a gift during life is tax exclusive while the estate tax is tax on the entire estate and is therefore tax inclusive.

For example, if a parent gives a child $1 million as a lifetime gift, using the 40 percent federal marginal tax rate, the gift tax would be $400,000 ($1,000,000 times 40 percent). The child receives $1 million and the parent pays gift tax of $400,000. It costs $400,000 to gift $1 million. If the parent does not make the lifetime gift, the estate tax on the $1 million gift would be $666,667 even though the rate is the same 40 percent. It costs $266,667 more to make the same gift because the entire estate is taxed before the $1 million goes to the child ($1,666,667 times 40 percent is $666,667 taxes and $1 million bequest). If the gift is made within 3 years of death, it comes back into the estate for estate tax purposes.

• The three-year rule is important with respect to New York State estate taxes as well. Any gifts made more than three years before the decedent’s death will not be included in the estate and will not reduce the New York State exemption amount available at death. So, for example, if a client had a $5,187,500 estate in 2013 and gifts $1 million to his beneficiary more than three years before his death, the $1 million gift would not reduce his New York State exemption of $4,187,500.

• New York also has a “cliff.” What this means is if a decedent’s estate exceeds the exemption by more than 5 percent, then the estate does not benefit from the exemption and the entire estate would be subject to New York State estate tax. The strategy would be to reduce the estate below that cliff so that the entire estate would not be subject to New York State estate tax. For example, if Mom dies on April 30, 2016, with a taxable estate of $4.3 million, the New York State estate tax would be $216,959. If she made a lifetime charitable gift of $112,500, the estate would have been reduced to $4,187,500 and the estate would save $216,959 in estate tax.

• In situations where the client has done sophisticated estate planning such as sales to defective grantor trusts, I advise the client to pay off the note prior to death. This makes the estate simpler and may avoid challenges by the IRS claiming that the sale and promissory note transaction was a transfer with a retained interest. Better to pay off the loan and avoid the challenge.

• Of course, whether there is a taxable estate or not, I always ask clients to review the named fiduciaries in the estate and make sure that they have chosen the best people for the job. Circumstances may have changed and it does not hurt to revisit their choices. • If the clients have revocable trusts, this is also a good time to make sure that the assets have been transferred to the trust and all retirement funds have named beneficiaries. Clients should make sure that they have copies of all beneficiary forms as the onus will be on the beneficiary to prove that they are a named designated beneficiary if the designation is somehow lost.

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

by -
0 1323
Eat a banana! We take in far too much sodium and not enough potassium.

By David Dunaief, M.D.

One of the most popular food additives is also one of the most dangerous: salt. We need salt, but not in excess. On the other hand, potassium is beneficial in our diet. However, we have the opposite problem with potassium: It is underconsumed.

More than 90 percent of people consume far too much sodium, with salt being the primary culprit (1). Sodium is found in foods that don’t even taste salty. Bread and rolls are the primary offenders, since we eat so much of them. Other foods with substantial amounts of sodium are cold cuts and cured meats, cheeses, pizza (which has both bread and cheese), fresh and processed poultry, soups, meat dishes, pastas and snack foods. Foods that are processed and those prepared by restaurants are where most of our consumption occurs (2).

By contrast, only about 2 percent of people get enough potassium from their diets (3). According to the authors of the study, we would need to consume about eight sweet potatoes or 10 bananas each day to reach appropriate levels. Why is it important to reduce sodium and increase potassium? A high sodium-to-potassium ratio increases the risk of cardiovascular disease by 46 percent, according to a study looking at more than 12,000 Americans over almost 15 years (4). In addition, both may have significant impacts on blood pressure and cardiovascular disease, while sodium may also impact multiple sclerosis and potentially other autoimmune diseases.

To improve our overall health, we need to tip the sodium-to-potassium scales, consuming less sodium and more potassium. Let’s look at the evidence.

Reduced sodium

There are two studies that illustrate the benefits of reducing sodium in high blood pressure and normotensive (normal blood pressure) patients, ultimately preventing cardiovascular disease: heart disease and stroke.

The first study used the prestigious Cochrane review to demonstrate that blood pressure is reduced by a significant mean of −4.18 mm Hg systolic (top number) and −2.06 mm Hg diastolic (bottom number) involving both normotensive and hypertensive participants (5). When looking solely at hypertensive patients, the reduction was even greater, with a systolic blood pressure reduction of −5.39 mm Hg and a diastolic blood pressure reduction of −2.82 mm Hg.

This study was a meta-analysis (a group of studies) that evaluated data from randomized clinical trials, the gold standard of studies. There were 34 trials reviewed with more than 3,200 participants. Salt was reduced from 9 to 12 grams per day to 5 to 6 grams per day. These levels were determined using 24-hour urine tests. The researchers believe there is a direct linear effect with salt reduction. In other words, the more we reduce the salt intake, the greater the effect of reducing blood pressure. The authors concluded that these effects on blood pressure will most likely result in a decrease in cardiovascular disease.

In the second study, a meta-analysis of 42 clinical trials, there was a similarly significant reduction in both systolic and diastolic blood pressures (6). This meta-analysis included adults and children. Both demographics saw a reduction in blood pressure, though the effect, not surprisingly, was greater in adults. Interestingly, an increase in sodium caused a 24 percent increased risk of stroke incidence but, more importantly, a 63 percent increased risk of stroke mortality. The risk of mortality from heart disease was increased as well, by 32 percent.

In an epidemiology modeling study, the researchers projected that either a gradual or instantaneous reduction in sodium would save lives (7). For instance, a modest 40 percent reduction over 10 years in sodium consumed could prevent 280,000 premature deaths. These are only projections, but in combination with the above studies may be telling. The bottom line is decrease sodium intake by almost half and increase potassium intake from foods.

Potassium’s positive effects

When we think of blood pressure, sodium comes to mind, but not enough attention is given to potassium. The typical American diet is lacking in enough of this mineral.

In a meta-analysis involving 32 studies, results showed that, as the amount of potassium was increased, systolic blood pressure decreased significantly (8). When foods containing 3.5 to 4.7 grams of potassium were consumed, there was an impressive −7.16 mm Hg reduction in systolic blood pressure with high blood pressure patients. Anything more than this amount of potassium did not have any additional benefit. Increased potassium intake also reduced the risk of stroke by 24 percent. If this does not sound like a large reduction, consider that, by comparison, aspirin has been shown to reduce the risk of stroke by 20 percent.

This effect was important: The reduction in blood pressure was greater with increased potassium consumption than with sodium restriction, although there was no head-to-head comparison done. The good news is that potassium is easily attainable in the diet. Foods that are potassium rich include bananas, sweet potatoes, almonds, raisins and green leafy vegetables such as Swiss chard.

Multiple sclerosis

There are several very preliminary studies that suggest higher levels of salt may increase the risk of multiple sclerosis. One study showed that salt seems to increase the levels of interleukin-17-producing CD4 helper T cells (Th17), which are potentially implicated in autoimmune diseases such as multiple sclerosis (9). The researchers used mice to show feeding them high levels of salt resulted in high levels of Th17 cells and, as a result, a severe form of multiple sclerosis.

Lowering sodium intake may have far-reaching benefits, and it is certainly achievable. We need to reduce our intake and give ourselves a brief period to adapt — it takes about six weeks to retrain our taste buds, once we reduce our sodium intake. We can also improve our odds by increasing our dietary potassium intake, which also has a substantial beneficial effect, striking a better sodium-to-potassium balance.

References: (1) Am J Clin Nutr. 2012 Sep;96(3):647-657. (2) www.cdc.gov. (3) Am J Clin Nutr. 2012 Sep;96(3):647-657. (4) Arch Intern Med. 2011;171(13):1183-1191. (5) BMJ. 2013 Apr 3;346:f1325. (6) BMJ. 2013 Apr 3;346:f1326. (7) Hypertension. 2013; 61: 564-570. (8) BMJ. 2013; 346:f1378. (9) Nature. 2013 Mar 6.

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.

by -
0 1238

By Fr. Francis Pizzarelli

Recently, I participated in the Freshman Investiture Service at Joseph’s College in Patchogue. I have been privileged to be a faculty member in the social science department for more than 30 years. This service of welcoming is very simple. It is an ancient tradition practiced in many colleges and universities around the world as a formal way to welcome the new community of scholars and learners to the college. This year the theme for the Class of 2020 was integrity.

As I watched more than 500 college freshmen walk into our athletic center, representing every community on Long Island and beyond, I said to myself: “What an important theme for this class!” It seems that genuine integrity has truly been lost or buried in the rubble of human selfishness and narcissism. The present political and social landscape in our country seems to be devoid of any real sense of integrity.

What is true integrity? It is honesty, truth, principal, character and respect woven together in the fabric of one’s soul. It should be the foundation of every person’s life! It should shape how we treat each other, socially, politically, morally and religiously. Integrity is critical to sustaining a peaceful and respectful world.

Unfortunately, it seems like some people in power on every front have lost their way in this regard. Dishonesty and lack of respect is infectious everywhere. It wears many faces. It is the senseless violence in our streets. It is the blatant lack of respect for people who risk their lives to protect us every day — as well as the lack of respect on the part of some who use their power abusively.

We lack integrity when we discriminate against people because of their religion, their sexual orientation, their immigration status, their race and their ethnic origin. That Investiture Service provided for me a renewed sense of hope because more than 500 college coeds were reminded in a variety of ways of how profound and important real integrity is, if they hope to reach their goals and live their dreams.

The world desperately needs a new generation of leaders who are grounded in integrity. The class of 2020 potentially has the next generation of business leaders, college professors, compassionate doctors, lawyers and trades persons. The next generation of political leaders are among this class; our next representatives and senators and possibly the next president of the United States of America!

We must work hard to change the national discourse because of our integrity. We must work harder at being more inclusive, less judgmental; we need to build less walls and better bridges. We need to celebrate that which unites us and not that which divides us. We must focus on building people up and empowering the next generation to use their gifts and talents to make the world a better and more peaceful place to live. Hopefully, we in education will challenge the members of the class of 2020 to strengthen their integrity as they begin this new chapter in their lives.

Fr. Pizzarelli, SMM, LCSW-R, ACSW, DCSW, is the director of Hope House Ministries in Port Jefferson.

by -
0 93
Elizabeth Monroe

By Leah S. Dunaief

Leah Dunaief

History came alive on the distaff side last Monday night, as Elizabeth Kahn Kaplan talked about the nine first ladies born in New York State. Kaplan, a longtime resident of this area, author and prominent member of the Three Village Historical Society, combined her appreciation for history and art with delicious details from the lives of the nine women to make a delightful and informative evening at the Setauket Neighborhood House.

So who are those women?

Some of them we can tick off readily: Eleanor Roosevelt, Jackie Kennedy, Barbara Bush and Nancy Reagan. Others are shrouded in more distant history. They are the wives of Presidents Monroe, Van Buren, Tyler, Cleveland and Fillmore.

Here is an example of one of Kaplan’s anecdotes about these women. Elizabeth Monroe, born of an aristocratic Loyalist family in 1768, who disregarded the disapproval of her father to go ahead and marry the patriot James Monroe, is generally credited with saving the life of Madame de Lafayette. The wife of the French hero of the American Revolution was incarcerated as a result of her aristocratic heritage during the Reign of Terror and about to be guillotined, as had been her grandmother, mother and sister before her. At the time, Monroe was the ambassador to France, but was unable to officially intercede. Elizabeth Monroe, not bound by diplomatic constraints, acted on her own and publicly went to visit Mme. Lafayette in prison, promising to return each day. Not wanting an appearance of conflict with America, the French authorities released Mme. Lafayette the next day.

When Monroe became president, did the American public appreciate his wife? They did not, as Kaplan reported. She was far too elegant and aristocratic for American tastes.

Tyler’s wife, Julia Gardiner, born on Gardiner’s Island, was known a bit infamously as the “rose of Long Island” and was called “madam presidentress,” the term “first lady” not having been coined until much later. Gardiner was Tyler’s second wife, and she attracted a lot of attention by being the first to marry a sitting president and for being 30 years younger than him. Tyler’s eldest daughter was five years older than her stepmother.

And so the stories unfolded, Kaplan keeping her audience totally engaged for well over an hour. Martin Van Buren, the first president to be born after American independence, and the only president to speak English as a second language, married his childhood sweetheart, Hannah Hoes. She spoke Dutch at home with her husband and was his first cousin once removed. Millard Fillmore married Abigail Powers, a schoolteacher. Both were upstate New Yorkers.

Grover Cleveland, who served two terms, but not consecutively, married Frances Folsom, a woman 22 years younger. A bachelor when he entered office, he married the daughter of a close friend. He had looked after her as executor of his friend, Oscar Folsom’s, estate and simply waited until she was old enough before they married. At 21, Frances was the youngest first lady, and she was well-liked. She is appreciated for having started kindergarten in schools.

The other first ladies are well known to us. Eleanor Roosevelt is credited as the most influential and active first lady in our history. The longest-serving first lady, as wife of four-term president Franklin Roosevelt, she went on to a public life of her own. Jackie Kennedy became an American idol and is known for her cultural efforts and redecorating the White House. Barbara Bush, with her forthright style, her constant loyalty and support of her family, and refusal to dye her hair when her husband became president, was always a more popular figure than he. And Nancy Reagan, Ronald Reagan’s second wife, was a diminutive and elegant first lady whose life was dedicated to protecting her husband after the assassination attempt that wounded him and his press secretary.

They are fascinating women and we can claim them as our own.

by -
0 1303
Depending on the variety, irises bloom late spring to midsummer. Photo by Ellen Barcel

By Ellen Barcel

Autumn is the time to plant your new spring flowering bulbs. They can be planted up until the ground freezes, usually in December. Buy the best quality you can afford and you will be rewarded with a great garden next spring.

Snowdrops. Photo by Ellen Barcel
Snowdrops. Photo by Ellen Barcel

• Don’t overlook the tiny bulbs. They’re not as showy as tulips and daffodils but are ideal in small areas and rock gardens. Crocuses, of course, come to mind, but I have windflowers in my garden coming back for decades. Other small bulbs include the super early white snowdrops, just four to six inches high, and anemone with their daisy-like flowers. There are also tiny varieties of the standards. ‘Lilac Wonder’ is a miniature tulip, lilac and bright yellow in color. ‘Pipit Daffodil,’ another miniature, is white and pale yellow. A unique, and small, daffodil is ‘Golden Bells,’ which produces a dozen or more flowers from each bulb. It’s just six to eight inches high and blooms in late spring to early summer.

• If you’re looking for very fragrant flowers, consider hyacinth. Although, like most spring flowers, the bloom is short-lived, their perfume is exquisite. ‘Gipsy Queen’ is a soft apricot color, ‘Jan Bos’ is a carmine-red, and ‘Woodstock’ is maroon. Some daffodils are also very fragrant. Check the package or the catalog description.

Daffodils. Photo by Ellen Barcel
Daffodils. Photo by Ellen Barcel

• If you do go with daffodils and tulips, consider at least some of the more unique ones. ‘Mount Hood’ is a daffodil that has gigantic white flowers, and ‘Green Eyes,’ also a white flower, has a green cup. ‘Exotic Mystery’ is almost completely a pale green while ‘Riot’ has reddish-pink cups. Among the tulips there are double flowers, a wide range of colors and even stripped ones. ‘Ice Cream’ is a really unique tulip. It has white center petals, surrounded by deep pink and green ones. It’s really exquisite. ‘Strawberry Ice Cream’ resembles a peony flower, in deep pink and green.

• Try some new (to you) and unusual bulbs. For example, ‘Candy Cane’ sorrel (oxalis) has white flowers tinged in red. They bloom in spring and even into summer. Another really unusual flower is the dragon flower. The bloom is maroon with a spathe that grows up to three feet. This is a big one and really unusual.

Tulips. Photo by Ellen Barcel
Tulips. Photo by Ellen Barcel

• Remember that certain bulbs are very attractive to squirrels, particularly tulips. There are several ways of handling this problem. One is to surround the tulip bulbs with daffodils. Squirrels don’t like daffodils and will generally stay away from them and the tulips they surround. A second way of dealing with this problem is to plant the tulip bulbs in wire cages. A third possibility, one I heard a planter recommend, is to overplant, that is, plant many more, possibly up to 25 percent more, bulbs than required. That way, the squirrels get some and some survive to grow in the spring.

• If you miss this planting window and the ground is frozen, there are several things you can do. The usual recommendation is to put the bulbs in the fridge until the ground thaws enough to plant them. You could also try planting them in pots and storing the pots in an unheated garage.

• The bulbs you plant this autumn will produce gorgeous flowers next spring. This is based on the professional growers’ treatment of the bulbs. They’ve grown them under ideal conditions, watered and fertilized them. To have them flourish in future years there are several things you need to do. One is to leave the green leaves on the bulbs after the blooms have faded. This is providing food for next year. You also need to add some fertilizer, again to help the bulbs for the following seasons. Make sure you water them in times of drought, even though by midsummer the leaves will have disappeared.

• Because spring bulbs basically disappear from the landscape by midsummer, they are ideal for beds where you intend to plant annuals. Plant the annual seeds in spring and by the time the bulbs have bloomed and faded, the annuals will have started to thrive.

• While you’re planting your spring flowering bulbs, consider also planting lilies, daylilies, peonies and hostas. All are perennials and will reward you next growing season.

Ellen Barcel is a freelance writer and master gardener. To reach Cornell Cooperative Extension of Suffolk County and its Master Gardener program, call 631-727-7850.

Prev1...367368369...373Next Page 368 of 373
TBR News Media is your local news and entertainment website.
We provide you with the latest breaking news and information for your community.
Contact us: [email protected]

Most Viewed

©