Columns

METRO photo

By Bob Lipinski

The changing colors reflect the season of autumn, the activity of harvesting grapes to make wine. Large gondolas are filled to the brim as workers fastidiously cut the sugar-laden grape clusters from the vine. Then they are loaded onto trucks to the winery, which signals the beginning of making wine.

Although I’m not making wine this year, I decided to host a “Harvest Wine Dinner” with some friends. We started with appetizers and went through several courses, ending with cheese. Two food offerings were paired with each wine.

Appetizers

Bruschetta with pesto

Green olive tapenade toasts

2022 Stag’s Leap Wine Cellars “AVETA” Sauvignon Blanc, Napa Valley, California. Blend of Sauvignon Blanc, Sauvignon Musqué, Sémillon, and Muscat Canelli. (Aged 6 months in stainless steel and older French oak.) Lively fruity aroma and taste of tropical fruit, lychee, lemongrass, and orange peel. Additional flavors of Meyer lemon, green apple, and wet stone.

First Course

Penne all’arrabbiata

Wild mushroom risotto with zucchini strips

2021 Ancient Peaks Renegade “Red Blend” Paso Robles, California. Blend of Syrah, Petit Verdot, and Malbec. (Aged 20 months in French and American oak.) Bold aromas and flavors of blueberry, roasted coffee, black plum, boysenberry, and toasted oak. Hints of cedar, tobacco, and cola. Outstanding balance and aftertaste.

2019 Brassfield “Perspective” Syrah, Lake County, California. Aged 30 months in new oak. Dark colored with an intense bouquet and flavor of cassis, black coffee, figs, prunes, and mint. Cola-like with jam, black peppercorns, smoked bacon and plums. Round and warming in the mouth with hints of toffee.

Main Course

New York strip steak brushed with extra-virgin olive oil and served with grilled asparagus

Blackened filet mignon served with charred broccoli rabe

2021 Stag’s Leap Wine Cellars “Artemis” Cabernet Sauvignon, Napa Valley, California. Aged 15 months in French oak. Powerful, yet gentle tasting with flavors of boysenberry, dark plum, baking spices, chocolate-cherry, and anise. The aftertaste is elegant, with hints of cocoa.

2020 Oyster Ridge “Red Blend” Paso Robles, California. Blend of Cabernet Sauvignon, Cabernet Franc, Petit Verdot, Merlot, and Malbec. (Aged 23 months in French oak.) Huge bouquet of dark fruit, espresso, and mint. Flavors of cassis, black olives, boysenberry, and spicy oak. Powerful aftertaste!

Cheese Course

Bra (cow’s milk cheese from Piedmont)

Aged Gorgonzola: tangy, superbly rich, pungent, salty, spicy-peppery flavor with large blue-green veins

2020 Burlotto “Verduno Pelaverga,” Cuneo, Piedmont, Italy. A bouquet and flavor of raspberry, black pepper, red currants, and spices. Quite smooth with an aftertaste of bay leaf and cherry.

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 consults and conducts training seminars on Wine, Spirits, and Food and is available for speaking engagements. He can be reached at boblipinski.com OR [email protected].

Pixabay photo
A Column Promoting a More Earth-Friendly Lifestyle

By John L. Turner

John Turner

Recent research has documented that birds are attracted to, but often disoriented by, outdoor lighting. There are many instances of migrating birds flying over suburban and urban areas becoming entrained in these areas, attracted by the glow of countless buildings and street lights. Unfortunately, this often leads to fatal consequences for birds as they collide with the windows that adorn so many modern urban and suburban buildings. 

The death of more than one thousand birds flying into the glass facade of McCormick Place in Chicago in October of last year is a stark reminder of the danger that excessive lighting can pose to birds.  

What can you do as a home or business owner? Very simple and straightforward — shut off excessive outdoor lighting to reduce your contribution to the upward glow that negatively affects birds. Before you automatically throw on the light switch controlling the outdoor lights give a thought about the birds flying overhead during their winged journeys.

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

 

Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. Stock photo
Other disorders may contribute to the condition

By David Dunaief, M.D.

Dr. David Dunaief

If you are among the estimated 10 to 15 percent of the population that suffer from irritable bowel syndrome (IBS) symptoms, managing them can be all-consuming (1). IBS symptoms, which can include abdominal pain, cramping, bloating, constipation and/or diarrhea, have a direct effect on your quality of life.

While there is no single test that provides an IBS diagnosis, physicians eliminate other possibilities and use specific criteria to provide a diagnosis.

The Rome IV criteria are an international effort to help diagnose and treat disorders of gut-brain interaction (2). Using these criteria, which include questions about the frequency of pain over the past three months alongside a physical exam, helps provide a diagnosis.

Once diagnosed, first-line treatment typically involves lifestyle modifications, including dietary changes. Let’s look at what the research tells us.

Is IBS affected by mental state?

The “brain-gut” connection refers to the direct connection between mental state, such as nervousness or anxiety, to gastrointestinal issues, and vice versa.

Mindfulness-based stress reduction was used in a small, but randomized, eight-week clinical trial with IBS (3). Those in the mindfulness group (treatment group) showed statistically significant results in decreased severity of symptoms compared to the control group, both immediately after training and three months post-therapy.

Those in the treatment group were instructed to do meditation, gentle yoga and “body scanning” — focusing on one area of the body for muscle tension detection. The control group attended an IBS support group once a week.

A subsequent meta-analysis of six randomized controlled trials (RCTs) that studied the effects of mindfulness on IBS found that the combined study group achieved improved quality of life and lower pain scores, perceived stress anxiety, and visceral sensitivity than the control group (4).

Interestingly, a 2021 international study of more than 50,000 participants found that there were some genetic similarities among those who suffer from IBS and those who suffer from common mood and anxiety disorders such as anxiety, depression, and neuroticism, as well as insomnia. As the authors wrote, “Although IBS occurs more frequently in those who are prone to anxiety, we don’t believe that one causes the other – our study shows these conditions have shared genetic origins, with the affected genes possibly leading to physical changes in brain or nerve cells that in turn cause symptoms in the brain and symptoms in the gut” (5). In other words, they may have a common cause.

Is gluten a factor?

Gluten sensitivity may be an important factor for some IBS patients (6).

In a small randomized clinical trial, patients who were given gluten were more likely to complain of uncontrolled symptoms than those who were given a placebo, 68 percent vs. 40 percent, respectively (7). These results were highly statistically significant, and the authors concluded that nonceliac gluten intolerance may exist. 

What role does fructose play?

Some IBS patients may suffer from fructose intolerance. In a study, IBS researchers used a breath test to explore this possibility (8). The results were dose-dependent, meaning the higher the dose of fructose, the greater the effect researchers saw. When patients were given a 10 percent fructose solution, only 39 percent tested positive for fructose intolerance, but when they were given a 33 percent solution, 88 percent of patients did.

The symptoms of fructose intolerance included gas, abdominal pain, bloating, belching and alternating bowel habits. The authors concluded that fructose avoidance may reduce symptoms in some IBS sufferers.

According to another study, about one-third of IBS patients are fructose intolerant. When on a fructose-restricted diet, symptoms appeared to improve (9). Foods with high levels of fructose include certain fruits, like apples and pears.

Is lactose intolerance a contributor?

According to another small study, about one-quarter of patients with IBS also have lactose intolerance (10). 

Of the IBS patients who were also lactose intolerant, there was a marked improvement in symptoms at both six weeks and five years when placed on a lactose-restricted diet.

Though the trial was small, the results were statistically significant. Both the patient compliance and long-term effects were excellent, and outpatient clinic visits were reduced by 75 percent.

Will probiotics help?

A study that analyzed 42 trials focused on treatment with probiotics shows there may be a benefit to probiotics, although each trial’s objectives, or endpoints, were different (11).

Probiotics do show promise, including the two most common strains, Lactobacilli and Bifidobacteri, which were covered in the review.

All of these studies provide hope for IBS patients — and the research is continuing with assessments of peppermint oil consumption and gut-directed hypnotherapy, among others. Since the causes can vary, a strong patient-doctor relationship can assist in selecting an approach that provides the greatest relief for each patient’s symptoms.

References:

(1) American College of Gastroenterology [GI.org]. (2) J Neurogastroenterol Motil. 2017 Apr; 23(2): 151–163. (3) Am J Gastroenterol. 2011 Sep;106(9):1678-1688. (4) J Clin Med. 2022 Nov; 11(21): 6516. (5) Nat Genet 53, 1543–1552 (2021). (6) Am J Gastroenterol. 2011 Mar;106(3):516-518. (7) Am J Gastroenterol. 2011 Mar;106(3):508-514. (8) Am J Gastroenterol. 2003 June; 98(6):1348-1353. (9) J Clin Gastroenterol. 2008 Mar;42(3):233-238. (10) Eur J Gastroenterol Hepatol. 2001 Aug;13(8):941-944. (11) Aliment Pharmacol Ther. 2012 Feb;35(4):403-413.

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.

Apple Raisin Strudel

By Heidi Sutton

From apple strudel to an easy apple galette to bourbon grilled apples, these delicious desserts for fall will have you ready for sweater weather!

Apple Raisin Strudel

Recipe courtesy of Envy Apples

Apple Raisin Strudel

YIELD: Makes 4 to 6 servings

INGREDIENTS: 

3 large tart apples

1/4 cup raisins

1/4 cup chopped pecans or pistachios

1/2 teaspoon pumpkin pie spice

1/2 cup ground almonds or almond flour

1 tablespoon cornstarch

6 sheets filo pastry dough

1/2 cup butter, melted

1/4 cup chopped pistachios + 1 tbsp sugar

DIRECTIONS:

Peel and core the apples and slice thinly. In a large bowl combine apple slices, raisins, pecans, pumpkin pie spice, ground almonds and cornstarch and toss together. Pre-heat the oven to 375 degrees F and line a cooking tray with baking paper. Lay out the first sheet of filo on a clean counter top and brush with melted butter. Top with another layer of filo, continue with remaining sheets, buttering in between. Arrange the apple slices on the filo pastry in a neat log down the center of the longest side, leaving about 2 inches open at each end. 

Carefully fold each end in and roll the pastry up to encase the filling and form a log. Place on the prepared tray with the seam underneath. Brush the pastry all over with the butter and sprinkle with pistachios and sugar. Bake for 30-40 minutes or until the pastry is golden. 

Easy Apple Galette

Recipe courtesy of Jazz Apples

Easy Apple Galette

YIELD: Makes 8 servings

INGREDIENTS: 

1 11-inch pie crust, at room temperature

2 tbsp light brown sugar

1 tsp ground cinnamon

2 large apples cored and thinly sliced

Juice from 1/2 lemon

1 egg white

DIRECTIONS:

Preheat oven to 400°F. Line a large rimmed baking sheet with parchment paper. *If you don’t have parchment paper just make sure you spray your baking sheet In a medium bowl, combine sliced apples, brown sugar, lemon juice, cinnamon, and a pinch of salt. Gently stir to coat apples. Arrange apple slices on top of dough, try making a circle pattern. Leave a 1 in – 1.5 in border around the edge. Fold the edges towards the center. Repeat until all edges are folded towards the apple slices. Whisk egg white in a small bowl; brush over the crust edges. Bake for approximately 40 minutes so the edges are golden brown and the apples are soft. 

Bourbon Grilled Apples

Recipe courtesy of Envy Apples

Bourbon Grilled Apples

INGREDIENTS: 

6 medium to large apples

2 cups bourbon

1/2 cup brown sugar

2 cups ricotta cheese

Cinnamon

Granola

DIRECTIONS:

Slice apples into rounds and remove the core. Marinate the rings in the bourbon for 5 minutes. Place rings on the grill until desired tenderness. Remove from grill, sprinkle with sugar and broil until golden brown. Plate rings, add ricotta, then top with cinnamon and granola.

Ellen Pikitch at the United Nations when she spoke at the 9th International Day of Women and Girls in Science back in February. Photo from E. Pikitch

By Daniel Dunaief

Even as Covid threatened the health of people around the world, a group of 30 leading researchers from a wide range of fields and countries were exchanging ideas and actions to ensure the sustainability of ocean fisheries.

Starting in 2020, the researchers, including Stony Brook University’s Endowed Professor of Ocean Conservation Science Ellen Pikitch, spent considerable time developing operating principles to protect the oceans and specific actions that could do more than ensure the survival of any one particular species.

Earlier this week, the researchers, who come from fields ranging from biology and oceanography to social sciences and economics, published a paper titled “Rethinking sustainability of marine fisheries for a fast-changing planet” in the Nature Journal npj Ocean Sustainability, as well as a companion 11 golden rules for social-ecological fisheries.

The researchers, who were led by first author Callum Roberts, Professor of Marine Conservation at the University of Exeter, plan to share their framework with policy makers and government officials at a range of gatherings, starting with Brussel’s Ocean Week and including the United Nations Ocean Conference in Nice.

“We felt something like this was needed in order to reach these audiences effectively,” said Pikitch.

The extensive work, which included two series of workshops, outlines ways to regenerate the ocean’s health and to put people before profits.

The authors suggest that fisheries need to address their contributions to the climate crisis through activities that are polluting, such as dumping fishing gear or plastics in the ocean, carbon intensive or destructive, through the disturbance of sediment carbon stores.

The paper suggests that lost or discarded fishing gear often make up the largest category of plastic waste in the open sea. This gear is not only polluting, but leads to ghost fishing, in which fish die in abandoned or discarded nets.

The authors suggest that labelling fishing gear could encourage better stewardship of the ocean. They also argued that fisheries management has historically focused on economic output, without considering social value and effects.

“We take the view that marine life is a public asset, and its exploitation and management should work for the benefit of local communities and the public,” the authors wrote in their paper.

Pikitch described the work as an “urgent” call to action and added that the researchers will be “meeting with policy makers, retailers, fishery managers and others to discuss these results and how they can be implemented.”

The researchers engaged in this effort to find a way to compile a collection of best practices that could replace a hodgepodge of approaches that overlook important elements of sustainability and that threaten fish species as well as ocean habitats.

“Fisheries are in bad shape worldwide and are degrading rapidly with overexploitation and climate change,” Philippe Cury, Senior Emeritus Researcher at the Institute of Research for Development in Marseille, France, said in a statement. “Efficient and renewed fisheries management can really help to restore marine ecosystems and to reconcile exploitation and biodiversity.”

Pikitch anticipated that some might offer pushback to the suggestions. “If you don’t get pushback, you’re probably not saying something that is important enough,’ she said.

Ecosystem focus

Using research Pikitch led in 2004 from a paper in Science, the group constructed one of the 11 actions around developing a holistic approach to the ocean habitat.

Pikitch’s expertise is in ecosystem based fishery management.

“Fish interact with one another, feed on one another, compete with one another and share the same habitats,” Pikitch said. “For those reasons alone and more, we need to stop managing species one at a time.”

Some policies currently protect ecosystems, including the spatial and temporal management of the Canadian lobster fishery to protect whales and the no-take marine reserves to protect artisanal reef fisheries in the Caribbean.

Still, these approaches need to be applied in other contexts as well.

While some people believed that researchers didn’t know enough to create and implement holistic guidelines, Pikitch and her colleagues suggested that it’s not “necessary to know everything if we use the precautionary principle.”

Pikitch suggested that the Food and Drug Administration takes a similar approach to approving new medicines.

The FDA requires that researchers and pharmaceutical companies demonstrate that a drug is safe and effective before putting it on the market.

Fisheries are making some headway in this regard, but “much more is needed,” she said.

Subsidy problem

The authors highlighted how government subsidies are problematic.

“Many fisheries are highly carbon intensive, burning large quantities of fossil fuels often made cheaper by capacity-enhancing government subsidies,” the authors noted in the paper. “Among the worst performers in terms of fuel burned per tonne of landing gears are crustacean fisheries, fisheries that operate in distant waters, deploy heavy mobile gears like trawls, or target high value, low yield species like swordfish; most of them propped up by subsidies.”

When overfishing occurs, companies switch to catching less exploited species, even when they don’t have any data about new catches. The new species, however, soon become overfished, the authors argued.

In urging fisheries management to support and enhance the health, well-being and resilience of people and communities, the scientists add that abundant evidence of widespread human rights abuses occurs in fishing, including coercive practice, bonded, slave and child labor and unsafe, indecent and unsanitary living and working conditions.

“Abuses at sea continue and more needs to be done to stop this,” Pikitch explained.

Additionally, the authors hope to give a voice to the global south, which is “often ignored in many of these discussions about how to appropriately manage these fisheries,” she suggested.

A beginning

While the paper was published, Pikitch explained that she sees this as the beginning of change and improvement in creating sustainable fisheries policies. She anticipates that the collection of talented scientists will continue the work of protecting a critical resource for human and planetary survival.

“This group will continue to work together to try get this work implemented,” she said. “I’m enormously proud of the result.”

Pixabay photo

By Daniel Dunaief

Daniel Dunaief

I’m getting messages every day and, often, several times a day. I must be really important.

As with snail mail, those messages could be delivering something extraordinary.

“We are writing to inform you that you’ve won a Pulitzer Prize, despite the fact that you haven’t entered anything and we haven’t yet created an extraordinarily average category.”

Or, perhaps, “we wanted to let you know that your cells are healthier than they’ve ever been and that you should keep up the good work. We’d like to study you to learn how your body is performing better than we’d expect for someone half your age.”

Then, of course, there are the realistic possibilities.

“Hey, want to go to dinner with us this weekend?”

That’s a nice message to receive from a friend or family member.

My son believes brevity is the soul of wit when it comes to messages so he’ll just write “Judge!!!!” or “Soto!!!!” or some combination of Yankee players who have performed well that day.

The most frequent messages I’m receiving are the ones from would-be political leaders, their pals, and other prominent supporters who not only want my vote, but also want me to contribute money.

I’d like to think these messages, with my name at the top, were written personally by these important people, who took the time out of their day to reach out to me.

“You know who I haven’t written to recently? Daniel Dunaief. I’ll just give him a holler to gauge his thoughts on one of the more important races.”

But, no, I know they’re not personal missives, just as I know Siri isn’t graciously saying “You’re welcome” even though she’s programmed to show appreciation in her chipper voice when I thank her.

Still, these messages have morphed from a nuisance into something else. In the frenzy and excitement of consequential races, these communiques are filled with fear and hope, often in that order. In a few short sentences, they tell me what’s at stake, what role I can play, and how these leaders will spend my money wisely.

Wouldn’t that be nice? If we donated to a campaign, wouldn’t it be great to see how our money, specifically, helped someone, as in, “this yard sign made possible by your moderately generous donation.”

If you’ve ever watched the show “Seinfeld,” George Costanza, played by Jason Alexander, suggests that he grows on people, the way ad jingles do. He is like an advertisement for Mennen deodorant. At first, you can’t stand the “byyyy Mennen” sound, but you find yourself singing it in the shower or humming it in the car.

Maybe, in some way, this unprecedented barrage of seemingly personal text messages has become like those jingles.

To be honest, I don’t read them carefully. I do, however, appreciate the earnestness with which someone sends them and I recognize that something consequential is about to happen.

Maybe it’s a bit like the December holidays. The anticipation of November 5th is exciting, even if the event itself might be lacking.

The reality of the election feels more like a gift certificate to a restaurant that serves a combination of my least favorite foods, all deep fried in a type of grease that triggers an allergic response. The election itself, as I see it, will likely have echoes from 2020, with lawyers and politicians exerting themselves, insisting that their candidate won for days or weeks after Nov. 5th.

An early riser, I grin when the message arrives an hour or so after I’ve gotten up and the person with the morning message apologizes for writing so early.

Really? Because you’re not actually sending the message and the machine that blasts them could pick any time in the day to release this particular text.

With all the money flowing into these campaigns, I wonder if the country invested all the cash both sides collected and put it in a certificate of deposit or a Treasury Bill and created scholarships, what kind of opportunities could we offer future students who one day might want to run for office.

Meet this week’s Shelter Pet of the Week, Bronco; a four-year-old male bully mix, adorning a gorgeous brindle with unique white patches up for adoption at the Smithtown Animal Shelter. Sadly, this innocent boy was cruelly abandoned at a local park. Despite his hardship, Bronco has warmed up to the team at the shelter who have come to discover what an endearing little charmer he is.

Bronco is a playful fella who fancies himself quite the athlete! His impressive ability to catch treats with precision, is a sight to behold! Bronco is not shy when it comes to letting you know he is looking for some playtime. He will hand deliver his favorite toys to your feet for a game of fetch or tug of war. This beefcake is young, healthy, and has a lifetime of adventures and companionship ready to share.

Bronco is a lady’s man who sincerely adores to be around women. He currently experiences some hesitancy and trust issues around men and other animals. This boy would be best suited in a home with no children or pets. He needs a patient home that can show him structure and love.

If you are interested in meeting Bronco, please call ahead to schedule an hour to properly interact with him in a domestic setting, which includes a Meet and Greet Room, the dog runs, and a Dog Walk trail.

The Town of Smithtown Animal & Adoption Shelter is located at 410 Middle Country Road, Smithtown. Visitor hours are Monday to Saturday from 10 a.m. to 3 p.m. (Sundays and Wednesday evenings by appointment only). For more information, call 631-360-7575.

For more information regarding rescue animals available for adoption visit:. TownofSmithtownAnimalShelter.com 

Photo from Pixabay

By Leah S. Dunaief

Leah Dunaief,
Publisher

As we enter October, we come upon the one year anniversary of our podcasting. We have had a gratifying response to our weekly offering, but for those who might not be aware of the particulars, let me explain.

A podcast, in general, can be about any subject, involve any number of people and have an unlimited reach. Our podcast, which we call The Pressroom Afterhour, and record Thursday evenings, consists of a quick summary of the past week’s local news, followed by conversation among our editorial board members about key stories that appear in that day’s issue of the newspaper. It is more than a summary, rather it’s like overhearing our chatter in the newsroom. There is more information, some laughter, a personal touch from our staff and an extra dimensionality to hearing the voices. 

Our podcast lasts about 40 minutes and is available after noon on Friday for the ensuing week. It is then archived and still available for anyone seeking a look-back at the news. To access the podcast easily, we have provided a QR code on the top right hand corner of our front page. Just mouse over it or take a picture of it with your cellphone. Another way is to go to our website, tbrnewsmedia.com, and click on the button at the top of the home page. The podcast is also available on Spotify.

We sometimes have a guest on with us, someone who features prominently in that week’s news. We think it is fun for you to hear from them in addition to reading about their actions. Some of our guests have been Historian Bev Tyler, Estate Planner Honorable Gail Prudenti, Geriatrician Dr. Suzanne Fields, Councilmember Jonathan Kornreich, Suffolk County Water Authority President Charlie Lefkowitz, and Elder Lawyer Nancy Burner, among others. We will have many more who have asked to be invited and who will round out the news.

Encouraged by the success of our news roundup, we have now started a second podcast, about one hour each time, that is a one-on-one interview with a prominent person. We call it, “Celebrity Interview,” and we began with the engaging actress Laura Benanti. It, too, can be found in the same way on the website or with Spotify.

We thank the sponsors of the podcasts for supporting this local news vehicle. They are included in a weekly full page ad in which we explain what topics will be covered in the session. These have featured the Port Jefferson Coffee House Toast, the Bridgeport-Port Jefferson Ferry, D.J.’s Clam Shack in Stony Brook, the Smithtown caterer Elegant Eating,  the Suffolk County Water Authority and Stony Brook University. These sponsors are deeply rooted in our communities and now in our weekly chronicles of local history.

For those of you who might want to offer feedback to a particular podcast, please do so by writing us a letter to the editor, emailing us at [email protected], or calling us at 631-751-7744. We would welcome your comments and any suggestions you might have for guests, including yourselves. 

We view these podcasts as possible forums for the local news.

METRO photo
Removing iron accumulation may improve results

By David Dunaief, M.D.

Dr. David Dunaief

Patients with Parkinson’s disease (PD) suffer from a variety of movement disorders caused by a breakdown of brain neurons. While we don’t fully understand the causes of PD, we know that risk factors may include head trauma, genetics, exposure to toxins and heavy metals, and other issues, such as a sedentary lifestyle.

The prime culprit is dopamine deficiency that occurs in a region at the base of the brain (1). Because of this, the mainstay of medical treatment has been adding back dopamine; however, eventually the neurons themselves break down, and the medication becomes less effective.

Newer approaches include medications and deep brain stimulatory surgery, as well as modifying lifestyle, considering factors like iron, inflammation, CoQ10, and vitamin D. While the research is not conclusive, it is continuing. This provides us with hope and more options.

Iron accumulation

Iron accumulation is potentially harmful in neurodegenerative diseases such as Parkinson’s disease, as well as Alzheimer’s disease, macular degeneration, and multiple sclerosis, because of the oxidative damage it can cause.

In a small, yet well-designed, randomized controlled trial (RCT), researchers used a chelator to remove iron from the substantia nigra. An iron chelator is a drug that removes the iron. Here, deferiprone (DFP) was used at a modest dose of 30 mg/kg/d (2).

The chelator reduced the risk of disease progression significantly on the Unified Parkinson Disease Rating Scale (UPDRS) during the 12-month study. Participants who were treated sooner had lower levels of iron compared to a group that used the chelator six months later. A specialized MRI was used to measure the brain’s iron levels.

A subsequent small RCT of 22 early-onset PD sufferers found a trend for improvement at the same dosing of DFP, results did not achieve statistical significance by the conclusion of the six-month trial (3). 

An iron chelator does not affect systemic levels of iron, only those in the substantia nigra region of the brain. The chelator may work by preventing degradation of the dopamine-containing neurons. Your physician may also recommend that you consume foods that contain less iron.

Inflammation

In a 2023 study, researchers tested 58 newly diagnosed PD participants’ blood and compared their results to 62 healthy control participants to compare inflammatory markers (4). Some PD-arm participants had additional testing done, including cerebrospinal fluid samples and brain imaging.

Researchers found that those with PD had significantly higher brain inflammation levels than those without PD in specific regions. Their blood and cerebrospinal fluid also had high inflammatory markers. These measures correlated with worse visuospatial and cognitive scores.

While this study provides hints of possible treatments, we need additional studies to confirm whether the inflammation is a cause or an effect of PD.

Regardless, adopting a low-inflammatory diet might help mitigate some symptoms of PD or slow its advancement.

CoQ10

In an RCT, results showed that those given 1,200 mg of CoQ10 daily reduced the progression of the disease significantly based on UPDRS changes, compared to a placebo group (5). Other doses of 300 and 600 mg showed trends toward benefit, but were not significant. This was a 16-month trial in a small population of 80 patients. In this study, CoQ10 was well-tolerated at even the highest dose.

Unfortunately, a 2022 meta-analysis of CoQ10 studies concluded that it was not universally beneficial, even if some studies showed benefits for specific patients (6). The authors concluded that a personalized approach to its administration and follow-up is critical.

Vitamin D

Vitamin D may play dual roles of both reducing the risk of Parkinson’s disease and slowing its progression.

A prospective study of over 3000 patients showed that vitamin D levels measured in the highest quartile reduced the risk of developing Parkinson’s disease by 65 percent, compared to the lowest quartile (7). This is impressive, especially since the highest quartile patients had vitamin D levels that were insufficient, with blood levels of 20 ng/ml, while those in the lowest quartile had deficient blood levels of 10 ng/ml or less.

In an RCT with 121 patients, results showed that 1,200 IU of vitamin D taken daily may have reduced the progression of PD significantly on the UPDRS compared to a placebo over a 12-month duration (8). Also, this amount of vitamin D increased the blood levels by almost two times from 22.5 to 41.7 ng/ml. 

In a 2019 study of 182 PD patients and 185 healthy control subjects, researchers found that higher serum vitamin D levels correlated to reduced falls and alleviation of other non-motor PD symptoms (9).

Like other PD research, investigations into the role of Vitamin D are ongoing.

So, what are our takeaways? Though medication is the gold standard for Parkinson’s disease treatment, lifestyle modifications can have a significant impact on both its prevention and treatment. While each change in isolation may have modest effects, their cumulative impact could be significant.

References:

(1) uptodate.com. (2) Antioxid Redox Signal. 2014;10;21(2):195-210. (3) Sci Rep. 2017; 7: 1398. (4) Movement Disorders. 2023;38;5:743-754. (5) Arch Neurol. 2002;59(10):1541-1550. (6) J Pers Med. 2022 Jun; 12(6): 975. (7) Arch Neurol. 2010;67(7):808-811. (8) Am J Clin Nutr. 2013;97(5):1004-1013. (9) Neurologica. 2019;140(4):274-280.

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.

Olivia Ross’ bracelets, which read Stony Brook Strong or Save the Mill Pond. 100% of the proceeds are donated to reconstruction efforts. Photo courtesy Olivia Ross
Why we must show appreciation for our fellow man, every day

A month after the disastrous storm that rocked our North Shore communities, we are left wondering what is next.

State and federal politicians have given us big promises, pledging to offer considerable aid for rebuilding efforts, and that is largely for us to wait and see.

However, some of our local community members are taking matters into their own hands, and showing the world that they will not sit back idly and wait for others to take action — they will do now.

One example of a do-gooder that comes to mind is Port Jefferson resident Olivia Ross.

She has started an initiative whose sole aim is to save the Stony Brook Mill Pond, which she has cherished since her childhood years.

Her customized bracelets don the words “Save the Mill Pond” on one side and “Stony Brook Strong” on the other. To date, Ross has sold 100 bracelets, and received almost $1,000 dollars in donations.

It is people like Olivia that define patriotism. In a world of political unrest and uncertainty, people who aim to provide even a modicum of comfort to those in need are truly the models of what a citizen ought to be.

We must band together as one, and use tragedies like last month’s storm, and even last week’s reminder of the horror that was 9/11’s 23rd anniversary, as reminders that sadness brings out the best traits of the human spirit.

But, let us not wait for moments of heartache to help our fellow neighbor. Let’s follow the examples of the selfless, and do good today — and every day.

We can all surely use it!