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Matzo Brei

By Barbara Beltrami

Passover is the joyous Jewish holiday that celebrates the exodus of the children of Israel in ancient Egypt from slavery to freedom. As they fled, they had no time for their bread to rise, and that is how we came to eat matzos (unleavened bread) for Passover.

The matzo has come to present itself in many forms, although I think everyone’s favorite is still that pale square megacracker that is a wonderful support system for everything from butter to horseradish to jam to salsa and everything in between.

Since Biblical times, it has also managed to evolve into matzo meal, which then has become the foundation for all sorts of delicious recipes. That being said, my all-time favorites are the traditional ones for matzo balls, matzo brei, and matzo meal pancakes.

Matzo Balls

Matzo Balls

The butt of many a joke, especially at the expense of mothers-in-law, these little round gems turn chicken soup into a treasure.

YIELD: Makes 6 to 8 servings

INGREDIENTS:

2 eggs

¼ cup vegetable oil

¹∕₃ cup cold seltzer or club soda

¾ teaspoon salt

1 cup matzo meal

DIRECTIONS: Beat the eggs, oil, soda and salt together. Stir in the matzo meal, adding just enough to make a stiff batter. Chill for at least one hour. Form into 18 balls and cook for 30 minutes in boiling salted water or broth. Serve with chicken soup.

Matzo Brei

Matzo Brei

Not as familiar perhaps as matzo balls, matzo brei is broken up matzos soaked for a short time in warm water or milk, then mixed with beaten eggs and fried. It makes a great breakfast or side dish, and with the addition of whatever your imagination dictates, a delicious main dish.

YIELD: Makes 4 servings

INGREDIENTS:

4 eggs, beaten

1 scant teaspoon salt

1 heaping tablespoon grated onion (optional)

4 matzos

Butter or oil for frying

DIRECTIONS: Combine the eggs, salt and onion (if using). Break matzos into large bite-size pieces and soak in water or milk until softened but not mushy. Add to egg mixture and stir well. In a medium skillet heat the butter or oil; then add matzo mixture to it. Fry until lightly browned and heated through. Serve with maple syrup, apple sauce or sugar. If using onions, serve with sour cream or soft cheese.

Matzo Meal Pancakes

Matzo Meal Pancakes

Because of their crispy exterior and light interior, these pancakes are a nice change from regular ones.

YIELD: Makes 2 to 4 servings

INGREDIENTS:

3 egg yolks

½ teaspoon salt ½ cup cold water

¾ cup matzo meal

3 egg whites, stiffly beaten

Oil for frying

DIRECTIONS: Beat together the egg yolks, salt and water. Stir in the matzo meal; then gently fold in the egg whites. In a large nonstick skillet, heat oil, then drop the batter, one heaping tablespoon at a time, into it. Turn once to brown on both sides. Drain on paper towels. Serve with sugar and cinnamon, maple syrup, honey, fruit or jam.

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The front entrance to the new ambulatory care center. Photo from SBU

By L. Reuven Pasternak, M.D.

Dr. L. Reuven Pasternak

As a native Long Islander, I know that we Long Islanders like to have choices and flexibility in many aspects of our lives, and we’re not shy about saying so. Having choices and flexibility in the quality of medical care we receive is certainly no exception.

That is why, on March 1, Stony Brook Medicine opened a new, multispecialty ambulatory care center, Advanced Specialy Care, at 500 Commack Road in Commack. The new center has more than 30 specialties designed to meet the majority of families’ medical needs, all under one roof.

Not only does this provide convenience for you and your family, it provides peace of mind because it means you can expect to receive the high level of expertise and compassionate care Stony Brook Medicine primary care doctors and specialists are known to provide.

And if surgery or other specialty care or access to clinical trials is needed, you can go to Stony Brook University Hospital without any disruption in the continuity of your care. As part of the only academic medical center in Suffolk County, Advanced Specialty Care offers it all.

Stony Brook doctors located in the Commack facility include primary and specialty care internists and pediatricians, gynecologists and obstetricians, dermatologists, orthopedists and urologists, surgeons and neurosurgeons. We also have a complete imaging center on site to provide X-rays, mammograms, ultrasounds, bone densitometry, and CT and MRI scans.

Another indication of how committed we are to serving our patients in western Suffolk and beyond is the sheer size of our state-of-the-art facility. The Advanced Specialty Care center occupies nearly 120,000 square feet of space, with room to expand as additional services are added. The location is just minutes away from the Sunken Meadow Parkway (Sagtikos), the Northern State Parkway and the Long Island Expressway.

We want this to be as close to a one-stop shopping experience as possible for you and your family. Whether it’s for a regular checkup or something more, I hope you will take advantage of having the power of Stony Brook Medicine close by, under one roof, at Advanced Specialty Care in Commack.

Dr. L. Reuven Pasternak is CEO at Stony Brook University Hospital and vice president for health systems at Stony Brook Medicine.

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Jun Wang in her laboratory with a transmission x-ray microscope. Photo from BNL

By Daniel Dunaief

The first time is most definitely not the charm. That’s what Jun Wang and her colleagues at Brookhaven National Laboratory discovered about sodium ion batteries.

Wang, a physicist and lead scientist at the facility, looked deep into the inner workings of a sodium ion battery to determine what causes structural defects as the battery functions. As it turns out, the first time a sodium ion battery charges and discharges, it develops changes in the microstructure and chemical composition of iron sulfide. These changes, which degrade the performance of the battery, are irreversible during the first charging cycle.

“We found that the cracks happened during the first cycle, then, after that, the structure kind of reached equilibrium,” said Wang, who published her research in the journal Advanced Energy Materials. “All these changes happen during the first cycle.”

Collaborators from Brookhaven’s Photon Sciences and Sustainable Energy Technologies groups stand behind the new transmission x-ray microscope (TXM) at BNL’s National Synchrotron Light Source. From left: Yu-chen Karen Chen-Wiegart, Can Erdonmez, Jun Wang (team leader), and Christopher Eng. Photo from BNL

Sodium ion batteries are considered an alternative to lithium ion batteries, which are typically found in most consumer electronics. Like lithium, sodium is an alkali metal, which means that it is in the same group in the periodic table. Sodium, however, is more abundant and, as a result, considerably less expensive than lithium.

Using a synchrotron-based hard X-ray full-field microscope, Wang was able to see what happened when sodium ions moved into and out of an iron sulfide electrode through 10 cycles. “We can see this microstructure evolution,” she said.

Wang monitored the evolution as a function of time while the battery is charging and discharging. The results are the first time anyone has studied a sodium-metal sulfide battery with these tools, which provides information that isn’t available through other methods. “It is challenging to prepare a working sodium ion battery for the in operandi/in situ TXM study to correlate the microstructural evolution with its electrochemical performance,” she said.

Other researchers suggested that Wang has developed a following in the scientific community for her ground-breaking research. “She has a very good reputation in the area of X-ray nanotomography, applied to a wide range of different materials,” Scott Barnett, a professor of materials science and engineering at Northwestern University, explained in an email. “I am most familiar with her work on fuel cell and battery electrodes — I think it is fair to say that this work has been some of the best pioneering research in this area,” he said.

Barnett, who started collaborating with Wang in 2010 on measuring fuel cell and battery electrodes with X-ray tomography, suggested that Wang’s work on capacity loss “could certainly lead to new breakthroughs in improved batteries.”

In her most recent work with sodium ion batteries, Wang found that the defects start at the surface of the iron sulfide particles and move inward toward the core, Wang said. The microstructure changes during the first cycle and is more severe during sodiation. The particles don’t return to their original volume and shape. After the first cycle, the particles reach a structural equilibrium with no further significant morphological changes, she said.

In other cycles, the material does not show further significant morphological changes, reach a structural equilibrium and electrochemical reversibility. Wang and her colleagues confirmed these observations with X-ray nanotomography, which creates a three-dimensional image of the battery material while recording the change in volume.

Wang suggested that a way to reduce these structural defects could be to reduce the size of the iron sulfide particles to create a one-phase reaction. She will work with other collaborators on modeling and simulations that will enhance the design of future battery materials.

In addition to conducting research on batteries, Wang is an industrial program coordinator in the Photon Science Directorate at BNL. She works with industrial researchers and beamline staff to find and explore new opportunities in industrial applications using synchrotron radiation. She leads the industrial research program, interacting with user groups through consultation, collaboration and outreach.

To manage her research, which includes a lab of three other researchers, and to accomplish her mission as manager of an industrial research program, Wang jokes that she “spends 100 percent of her time” with each responsibility. “I try to do my best for the different things” she needs to do with her time, she said.

Jun Wang with her husband Qun Shen and their 11-year old son Sam in Waikiki last year. Photo from Jun Wang

A native of Wuhu, China, Wang earned her bachelor’s degree in physics from Anhui University in China and her doctorate in physics from the Chinese Academy of Sciences in Beijing. She worked at the Beijing Synchrotron Radiation Facility, which was the first synchrotron light source in China. During her doctoral training, she studied multilayer films using X-ray diffraction and scattering.

A resident of Poquott, Wang is married to Qun Shen, who is the deputy director for science at the NSLS-II. The couple has an 11-year-old son, Sam, who is a sixth-grade student at Setauket Elementary School. Shen and Wang met at an international X-ray crystallography conference in the early 1990s.

Shen trained in the United States after he graduated from Beijing University in 1980, when he went to Purdue University for his doctorate through the China-US Physica Examination and Application Program. The couple have worked together a few times over the years, including publishing a paper in Nature Communications. Wang is hoping that her work with battery research will lead to improvements in the manufacture and design of sodium ion batteries.

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Montauk daisies should be divided, if needed, in spring. Photo by Ellen Barcel

By Ellen Barcel

Coneflowers can be divided in spring or fall. Photo by Ellen Barcel

One of the nice benefits of growing perennials is that they come back year after year without replanting — it saves time, energy and money. However, as the years go by, perennial beds can become overgrown and need to have their plants divided.

When is the ideal time to divide your perennials? Perennials can be divided almost any time, but, ideally, don’t divide perennials in the summer since it will be harder to keep the new plants growing with the heat and lessened rain. In an emergency, for example, when having to clear part of your property for new construction, divide as needed even if it is 90 degrees outside. But this is an emergency situation rather than good planning and means you need to take extra care to keep the plants thriving.

Black-eyed Susans can be divided in spring or fall. Photo by Ellen Barcel

 

The rule of thumb is to divide spring and summer bloomers in the fall. That means that you should have already divided plants like hostas. Fall-blooming plants (like mums, asters, Montauk daisies, etc.) should be divided in spring. By dividing them at the appropriate time, more of the plant’s energy will go into growing new roots and leaves. However, always do some research on the specific plants you need to divide before digging up the perennial clump as some plant species can be very persnickety when it comes to dividing time. And, some plants, like black-eyed Susans and coneflowers can be divided in either spring or fall.

Some perennials need to be divided every three or four years, depending on how thickly they have grown. Others don’t need to be divided for many years, like peonies. If there were fewer flowers last year than in the past, it’s a sign the clump needs to be divided. If there is a bare spot in the center of the clump, that, too is a sign the perennials need to be divided.

Steps to follow:

• Look at the size of the clump and decide into how many pieces you want to divide the clump.

• If possible, dig the appropriate number of receiving holes before you actually cut the clump. This will lessen transplant shock. You can, naturally put one of the divisions back into the original hole.

• If you can’t plant the divisions immediately, wrap them in newspaper or burlap, dampen with water and store in a bucket in a cool, shady place. Plant them ASAP.

• It’s easiest to dig up and divide a clump of perennials after there has been a rainfall.

• Start digging at the drip line and work your way around the outside of the clump of perennials.

• Once you’ve lifted the clump, if possible, divide the rooted sections by hand. This will lessen root damage.

• If necessary, take a sharp spade or gardening knife (make sure you have thoroughly cleaned it first) and cut the clump into several sections, making sure that you have roots attached to each section.

• If there was a bare spot in the center of the original bed, do not replant that section, but rather discard it to your compost pile. • Make sure you add organic matter to the newly planted divisions of the perennials.

• Keep the new plants moist, but not soggy, until they have had time to establish themselves. Mulch would be useful here. In a few months, your new plants should be growing well.

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

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Chicken Satay with Peanut Sauce

By Barbara Beltrami

Ah, consider the lowly peanut relegated in most culinary estimations to its more popular descendant, peanut butter. True, you seldom see it on a restaurant menu or even in a cookbook. In western cultures it hardly bears mentioning unless you’re talking about something to munch with your martini. In eastern cultures, however, the peanut, also called the ground nut, plays a larger role in native cuisine.

The recipes below will give you a taste (pun intended) of how the peanut figures into both the western and eastern food cultures and exhibit its versatility according to traditional preferences.

Chicken Satay with Peanut Sauce

Chicken Satay with Peanut Sauce

YIELD: Makes 4 servings

INGREDIENTS:

For the marinade:

½ cup coconut milk

1 teaspoon curry powder

2 teaspoons fresh minced garlic

2 level teaspoons brown sugar

½ teaspoon salt

½ teaspoon freshly ground black pepper

²⁄₃ pound boneless, skinless chicken breasts, cut into 2-inch strips

For the peanut sauce:

1 cup coconut milk

1 tablespoon curry powder

½ cup peanut butter

²⁄₃ cup chicken broth

¼ cup brown sugar

2 tablespoons freshly squeezed lime juice

1 teaspoon soy sauce

½ teaspoon cayenne pepper

Salt to taste

DIRECTIONS:

For the marinade: Stir together the first six ingredients. In a medium bowl, toss with chicken, cover and refrigerate for two hours. If using wooden skewers, soak in hot water until ready to use.

For the sauce: In a small-medium saucepan over medium-high heat, stirring frequently, combine coconut milk, curry powder, peanut butter, chicken broth and brown sugar. Bring to a simmer and cook for 5 minutes until heated through. Remove from heat and stir in lime juice, soy sauce, cayenne pepper. Add salt to taste (You probably won’t need much). Set aside to keep warm.

Meanwhile heat grill to medium high, remove skewers from water and wipe dry, then thread marinated chicken onto them. Grill 5 minutes per side or until golden brown and cooked through. Remove to platter and ladle warm peanut sauce over them. Serve with rice and vegetable slaw.

Peanut, Carrot and Mango Salad

YIELD: Makes 4 servings

INGREDIENTS:

2 cups grated carrots

½ cup chopped roasted salted peanuts

3 tablespoons lemon juice

1-2 teaspoons sugar

One green chile pepper, seeded and diced

¼ cup red or yellow bell pepper, minced

2 tablespoons finely chopped cilantro

Salt, to taste

One mango, peeled and diced

DIRECTIONS: In a medium bowl, combine the carrots and peanuts. In a separate small bowl, whisk together the lemon juice, sugar, chile pepper, bell pepper and cilantro. Combine with peanut and carrot mixture. Add salt and mix again. Fold in mango. Serve immediately with chicken or lamb.

Peanut Brittle

Peanut Brittle

 

YIELD: Makes one pound

INGREDIENTS:

Butter for greasing pan

2 cups sugar

2 cups roasted salted peanuts

DIRECTIONS: Grease low-rimmed baking sheet. In a heavy skillet combine sugar with 2 tablespoons water. Cook over medium heat, stirring frequently, until mixture boils. Steadily, continue to cook, stirring occasionally, until mixture turns golden (it happens pretty quickly!). Stir in peanuts and immediately pour and spread mixture onto greased baking sheet. Allow to cool half an hour, until hard. Then break into uneven, asymmetrical pieces before serving with coffee or tea.

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By Linda Toga

Linda Toga, Esq.

THE FACTS: My friend Joe, a New York State resident, was never married, but he and his on-again off-again girlfriend had a son together. The child was 14 months old when Joe died without a will. Before his death, Joe spent most of his free time with his son who lives with the girlfriend in New York. My friend’s parents live in Ohio and did not know about the girlfriend, much less the baby. They were shocked to learn that a baby they did not even know existed was the sole heir to Joe’s estate. They are now insisting on a DNA test.

THE QUESTION: Can Joe’s parents insist that a DNA test be done to prove paternity?

THE ANSWER: Whether or not a DNA test is appropriate will depend on what steps Joe may have taken to establish paternity. If, for example, Joe signed a paternity acknowledgment, the Surrogate’s Court will not order a genetic marker test or DNA test.

Under Public Health Law 4135-B, the father of a child can establish paternity by signing a paternity acknowledgment immediately before or after an in-hospital birth of a child to an unmarried woman. The acknowledgment must be signed by both parents and witnessed by two people who are not related to either parent. The acknowledgment must be filed with the registrar along with the child’s birth certificate.

If neither parent rescinds the acknowledgment within 60 days of signing it, the acknowledgment is deemed conclusive evidence of paternity. While challenges to a paternity acknowledgment based upon fraud or duress can be brought, the burden of proof is very high.

Another way the paternity of a child born out of wedlock can be established is through an Order of Filiation. A proceeding to establish paternity may be brought in Family Court by the mother of the child, a person claiming to be the father, the child or the child’s guardian. Assuming adequate proof is submitted to the court, an order will be issued setting forth the relationship between the father and the child. Just as there is a 60-day period during which the paternity acknowledgment can be rescinded, the court has 60 days in which to vacate an Order of Filiation before it is deemed conclusive evidence of paternity.

If, during Joe’s lifetime, an order of filiation was issued stating that the girlfriend’s son was Joe’s child, Joe’s parents cannot demand a genetic marker or DNA test. If there is no paternity acknowledgment or Order of Filiation, Joe’s parents can insist that proof be presented establishing that Joe is the child’s father. In that case, genetic marker and/or DNA testing would certainly be appropriate.

Other evidence may include proof that Joe was providing child support or that he publicly held himself out as the child’s father. If paternity cannot be established, Joe’s parents are in line to inherit his estate. Such an unfortunate outcome could have easily been avoided if Joe discussed his situation with an experienced estate planning attorney and had a will prepared that expressed his desire to leave his assets to his son.

Linda M. Toga, Esq. provides legal services in the areas of estate planning, probate, estate administration, litigation, wills, trusts, small business services and real estate from her East Setauket office.

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Mice are very efficient transmitters of Lyme disease, infecting about 95 percent of ticks that feed on them.

By Matthew Kearns, DVM

I was listening to the radio and a segment was introduced as “How a Mouse Plague Is a Forbidding Forecast for Lyme Disease in the Northeast,” predicting 2017 as a particularly risky year for Lyme disease. I had always focused on how close deer came to a dog owner’s property when discussing the risk of Lyme disease. I realize now that I must also ask about mice.

I decided I need to do some more investigating myself. I started with a little coffee, a doughnut, and started pounding the streets (I pictured myself as a regular “Magnum PI”). OK, back to reality. Coffee yes. Anyone whose seen my waistline would say, “doughnut NO!” Lastly, I only pounded the streets of Bing, Google and the Veterinary Information Network.

The first stage of my investigation was to refamiliarize myself with the life cycle of the deer tick. I learned that there are four stages: egg, larvae, nymph (young adult) and adult. The larval stage is the first stage to feed, so they do not have Borrelia burgdorferi (the bacteria that causes Lyme disease) but can acquire it during their first feeding. The adult stage of the tick prefers deer; however, the larval and nymph stages prefer smaller mammals such as dogs, cats, possums and, most importantly, mice.

Another fun fact I learned is that although other mammals, such as possums, will regularly groom off or kill the ticks on them, mice tolerate these ticks on their bodies. It is estimated that a white-footed mouse can have anywhere from 10 to 50 ticks on its face and ears at a time, and mice are very efficient transmitters of Lyme disease (they infect about 95 percent of ticks that feed on them).

Once the larval and nymph stages have fed (and possibly ingested Lyme disease at the same time), it is off to another host. The next stage of my investigation was to find out why there is an upsurge in the mouse population. Was it weather related? Other environmental factors? Actually it had most to do with a downtick in the population of the natural predators of mice. Many call it “Suburban Sprawl.”

Hawks, foxes and owls are the natural predators of the white-footed mouse and these predators need large forests to survive. Today we have more of a fragmented landscape — plenty of smaller forests that are broken up by small farms, housing developments and roads. Mice are prolific at making babies and actually thrive in these environments. Unlike deer, mice will come right up to (and sometimes into) our homes with all these ticks.

The Centers for Disease Control and Prevention report about 30,000 cases of human Lyme disease annually, but many experts feel that number is not accurate and that there could be as many as 10 times that amount. I would say it is safe to assume that the risk is just as high, if not higher, for dogs. There is no Lyme vaccine currently available for humans, but there has been a safe and effective vaccine for dogs on the market for decades. Please be aware that the canine Lyme vaccine has to be a series of two vaccines three weeks apart, and then once annually to be effective.

So, if you didn’t finish the initial series, or there has been more than a year gap since your dog received the vaccine, please make an appointment with your veterinarian ASAP. I would recommend a discussion about flea and tick preventatives at that same visit.

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.

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How to defeat ISIS, save the economy and reunite the country

By Michael Tessler

Michael Tessler

Historically speaking, the United States economy tends to thrive in wartime. Americans become patriotic when faced with a great foreign menace. In times of crisis, we tend to buy American products. Our star-spangled workforce works harder and innovates quicker. Our domestic political disagreements seem smaller when we tackle something larger than ourselves. In these moments of dire necessity, we find common purpose. Under that pretense our nation was founded and through the centuries has propelled it to unparalleled success.

Thankfully, we do not need another world war to accomplish this spirit of unity. This may all feel impossible as the gap between our political factions has never felt wider. On every issue it seems partisanship dictates idleness and/or delinquency. So how do we bridge that gap? How do we break the ice? Well the answer is simple — by protecting it.

Climate change is the key to a new era of American greatness. Now, even if you don’t believe in climate change, hear me out. Before we can proceed, please remove the term “climate change” from your mind as some abstract scientific concept. Let’s personalize it, treat it in the same fashion we’d treat any great and terrible foreign power or dictator. It helps to imagine it with an evil little mustache. Envisioning it now? Good.

This Blue Scare (yes, as in excess water) threatens our homes, our livelihoods and our way of life. If we lose this literal “Cold” War, our cities and towns could be decimated not by atomic fire but by superstorms, erosion, dust bowls and flooding. Each day we wait, the Blue Menace grows stronger, melting glaciers and capturing our territory, inch by inch.

Let us form an iron curtain around the ozone layer, protect it from further damage and economically punish those who aide in its destruction. We must establish a great coalition of all civilized nations to combat this threat in an act of global unity, all the while strengthening and cementing our role as an international leader.

This Blue Menace has allied itself with our nation’s greatest physical enemy, ISIS. Their terrorist organization wants nothing more than for us to continue to ignore this mighty faceless foe. According to the United States Treasury and Dubai-based energy analysts, ISIS receives nearly $1 to $3 million a day selling oil. Meanwhile, the United States continues to be the global leader in daily oil consumption accounting for 20 percent of all global use each and every day.

By ending our addiction to oil, we could decimate the so-called Islamic Caliphate without dropping a single bomb. Without the money from that precious resource, they would be unable to remain an effective fighting force. Our nation would no longer have to maintain alliances with false friends, who have used their swaths of oil as leverage over our current state of dependence.

Meanwhile, we can commit that all investments in green energy jobs must be American. We can hire every single unemployed American to help build a modern and green infrastructure. We will see the greatest investment in public works since President Eisenhower built the interstate highway system. We will create a new generation of energy-producing highways (yes, that’s an actual thing), new energy fueling stations, bullet trains, green appliances and the vehicles of tomorrow.

Industry will boom and the workforce will grow as we upgrade and innovate many existing products and power plants. Regardless of how one views climate change, the economic possibility is real and should not be ignored.

One of the biggest concerns I’ve heard is how will communities that produce outdated energy sources be impacted? Though the merits of “clean coal” can be debated, it is simply not a renewable resource. Our economy cannot survive or remain competitive in the 21st century using finite resources.

We cannot and will not abandon those who live in coal and oil country either. We will continue to ensure that their communities thrive by transforming them into clean energy economic hubs, providing not just new jobs, but training and tax subsidies to aide in their transition. Their concerns are genuine and have a right to be heard.

As long as the United States can be fundamentally held hostage by oil, we are at-risk. We owe it to all those who have sacrificed, to our children, born and unborn, to the ideals of America itself, to create a country that relies solely on the ingenuity of its people rather than foreign pipelines and the fuel of a bygone century.

So let’s defeat ISIS, let’s grow the economy, let’s reunite our country, let’s do something bold — we have landed a man on the moon, and with that same American tenacity, we can harness the power of the sun.

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In recent studies, whole fruit was shown to actually reduce the risk of type 2 diabetes.
Some surprising results about lifestyle

By David Dunaief, M.D.

Most of us know that type 2 diabetes is an epidemic in America and continues to grow. Type 2 diabetes was thought to be an adult-onset disease, but more and more children and adolescents are affected as well. The most recent statistics show that 50 percent of teens with diabetes between the ages of 15 and 19 have type 2 (1). Thus, this disease is pervasive throughout the population.

Let’s test our diabetes IQ. See if you can determine whether the following items are true or false.

•Whole fruit should be limited or avoided.

•Soy has detrimental effects with diabetes.

•Plant fiber provides too many carbohydrates.

•Coffee consumption contributes to diabetes.

•Bariatric surgery is an alternative to lifestyle changes.

My goal is to help debunk type 2 diabetes myths. All of these statements are false. Let’s look at the evidence.

Fruit

Fruit, whether whole fruit or fruit juice, has always been thought of as taboo for those with diabetes. This is only partially true. Yes, fruit juice should be avoided because it does raise or spike glucose (sugar) levels. The same does not hold true for whole fruit. Studies have demonstrated that patients with diabetes don’t experience a spike in sugar levels whether they limit the number of fruits consumed or have an abundance of fruit (2). In another study, whole fruit actually was shown to reduce the risk of type 2 diabetes (3).

In yet another study, researchers looked at different whole fruits to determine their impacts on glucose levels. They found that berries reduced glucose levels the most, but even bananas and grapes reduced these levels (4) — that’s right, bananas and grapes, two fruits people associate with spiking sugar levels and increasing carbohydrate load. The only fruit that seemed to have a mildly negative impact on sugars was cantaloupe. Fruit is not synonymous with sugar. One of the reasons for the beneficial effect is the flavonoids, or plant micronutrients, but another is the fiber.

Fiber

We know fiber is important in a host of diseases, and it is not any different in diabetes. In the Nurses’ Health Study and NHS II, two very large prospective (forward-looking) observational studies, plant fiber was shown to help reduce the risk of type 2 diabetes (5). Researchers looked at lignans, a type of plant fiber, specifically examining the metabolites enterodiol and enterolactone. They found that patients with type 2 diabetes have substantially lower levels of these metabolites in their urine, compared to the control group without diabetes. There was a linear, or direct, relationship between the amount of metabolites and the reduction in risk for diabetes. The authors therefore encourage patients to eat more of a plant-based diet to get this benefit.

Foods with lignans include: flaxseed; sesame seeds; cruciferous vegetables, such as broccoli and cauliflower; and an assortment of fruits and grains (6). The researchers could not determine which plants contributed the most benefit. They believe the effect is from antioxidant activity.

Soy and kidney function

Soy sometimes has a negative association. However, in diabetes patients with nephropathy (kidney damage or disease), soy consumption showed improvements in kidney function (7). There were significant reductions in urinary creatinine levels and reductions of proteinuria (protein in the urine), both signs that the kidneys are beginning to function better.

This was a small but randomized controlled trial, considered the gold standard of studies, over a four-year period with 41 participants. The control group’s diet consisted of 70 percent animal protein and 30 percent vegetable protein, while the treatment group’s consisted of 35 percent animal protein, 35 percent textured soy protein and 30 percent vegetable protein.

This is very important since diabetes patient are 20 to 40 times more likely to develop nephropathy than those without diabetes (8). It appears that soy protein may put substantially less stress on the kidneys than animal protein. This negative effect with animal protein may be due to higher levels of phosphorus. However, those who have hypothyroidism should be cautious or avoid soy since it may suppress thyroid functioning.

Coffee

Coffee is a staple in America and in my household. It is one thing my wife would never let me consider taking away. Well, she and the rest of the coffee-drinking portion of the country can breathe a big sigh of relief when it comes to diabetes.

There is a meta-analysis (involving 28 prospective studies) that shows coffee decreases the risk of developing diabetes (9). It was a dose-dependent effect; two cups decreased the risk more than one cup. Interestingly, it did not matter whether it contained caffeine or was decaffeinated. This suggests that caffeine is not necessarily the driving force behind the effect of coffee on diabetes.

The authors surmise that other compounds, including lignans, which have antioxidant effects, may play an important role. The duration of the studies ranged from 10 months to 20 years, and the database was searched from 1966 to 2013, with over one million participants.

Bariatric surgery

In recent years, bariatric surgery has grown in prevalence for treating severely obese (BMI>35 kg/m²) and obese (BMI >30 kg/m²) diabetes patients. In a meta-analysis of bariatric surgery (involving 16 RCTs and observational studies), the procedure illustrated better results than conventional medicines over a 17-month follow-up period in treating HbA1C (three-month blood glucose measure), fasting blood glucose and weight loss (10). During this time period, 72 percent of those patients treated with bariatric surgery went into diabetes remission and had significant weight loss.

However, after 10 years without proper management involving lifestyle changes, only 36 percent remained in remission with diabetes, and a significant number regained weight. Thus, whether one chooses bariatric surgery or not, altering diet and exercise are critical to maintain long-term benefits.

There is still a lot to be learned with diabetes, but our understanding of how to manage lifestyle modifications, specifically diet, is becoming clearer. The take-home messages are: Don’t avoid whole fruit; soy is potentially valuable; fiber from plants may play a very powerful role in preventing and treating diabetes; and coffee may help prevent diabetes.

Thus, the overarching theme is that you can’t necessarily go wrong with a plant-based diet focused on fruits, vegetables, beans and legumes. And if you choose a medical approach, bariatric surgery is a viable option, but don’t forget that you need to make significant lifestyle changes to increase the likely durability over 10 or more years.

References: (1) JAMA. 2007;297:2716-2724. (2) Nutr J. 2013 Mar. 5;12:29. (3) Am J Clin Nutr. 2012 Apr.;95:925-933. (4) BMJ online 2013 Aug. 29. (5) Diabetes Care. online 2014 Feb. 18. (6) Br J Nutr. 2005;93:393–402. (7) Diabetes Care. 2008;31:648-654. (8) N Engl J Med. 1993;328:1676–1685. (9) Diabetes Care. 2014;37:569-586. (10) Obes Surg. 2014;24:437-455.

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.

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'A trip to the American Museum of Natural History was my idea of being in heaven.' - Elof Carlson

By Elof Axel Carlson

The life sciences are vast in the number of specialties that exist for those pursuing a career as a biologist. A majority of college biology majors are premedical or seek some sort of health-related field. As much as possible they hope the biology they learn will find its way into the health field they seek to enter. Persons who want to be scholars in biology are often motivated by a desire to know as much about life as they can. I was one of those from early childhood when a trip to the American Museum of Natural History was my idea of being in heaven.

Elof Axel Carlson

I loved learning about evolution and the diversity of life. I knew I wanted to be a geneticist when I was in ninth grade and learned about Paul Müller’s Nobel Prize work on inducing mutations. Like a duckling, I felt imprinted and wanted to work with Müller someday.

Graduate work was different. As a teaching assistant I got to see about 90 different specimens each week for the various organ systems displayed by students. Unlike the textbook perfect illustrations, veins and arteries could be slightly off in the specimens I looked at. Their colors differed. Their texture differed.

I also learned how much we didn’t know about life. For my specialty of genetics (with Müller, as I had hoped) I felt steeped in experimental design, techniques and ways of thinking. Doing a Ph.D. allowed me to examine a gene using the tools of X-raying to produce mutations of a particular gene and subtle genetic design to combine pieces of a gene — taking it apart and combining pieces that were slightly different. It gave me an insight into that gene (dumpy, in fruit flies) that for a short time (until I published my work) I was the only person in the world that knew its structure.

In my career I have taught biology for majors, biology for nonscience majors, genetics, human genetics and the history of genetics. I have taught lower division and upper division courses, graduate courses and first-year medical classes. I learned that sharing new knowledge with students excited their imaginations. I learned that the human disorders I discussed led to office visits; and if I didn’t know the information they sought, I went with them to the medical library and we looked up articles in the Index Medicus and discussed their significance.

Often that student was married and had a child with a birth defect (born without a thyroid, having a family trait that might appear like cystic fibrosis). I would prepare a genetic pedigree and give it to the student to stick in a family bible for future generations to read. I also delighted in going to meetings to discuss genetics with colleagues whose work I had read.

I was pleased that I shared a body plan with other mammals. I liked comparative anatomy, which taught me how other body plans work (mollusks, arthropods, worms, coelenterates, echinoderms). As a graduate student taking a vertebrate biology course, I went into a cave and plucked hibernating bats from a ceiling.

The world under a microscope is very different. To see amoebas, ciliated protozoans, rotifers and other organisms invisible to the naked eye or as mere dust-like specks is a thrill. I can go back in time and imagine myself as a toddler, a newborn, an embryo in my mother’s uterus or an implanting blastocyst rolling out of her fallopian tube. I can imagine myself as a zygote, beginning my journey as a one-celled potential organism typing this article into a computer. I can go back in time to my prehistoric ancestors and trace my evolution back to the first cellular organism (bacteria-like) more than 3 billion years ago.

I learned, too, that I contain multitudes of ancestors who gave me one or more of their genes for the 20,000 I got from my father’s sperm and the matching 20,000 genes in my mother’s egg nucleus. I contain some 37 trillion (that is, 37,000,000,000,000) cells or 2 to the 45th power, which means some 45 mitotic cell divisions since I was a zygote. I know that the warmth of my body is largely a product of the mitochondrial organelles in my cells that using the oxygen from the air I breathe and converting small molecules of digested food to provide energy that runs the metabolism of my body and disposes carbon dioxide that eventually is expelled from my lungs. This knowledge makes me aware of my vulnerability at the cellular level, the chromosome level and the genetic level of my DNA to the agents around me that can lead to birth defects cancers, and a premature aging.

Knowing my biology allows me to know my risks as well as new ways to celebrate my life.

Elof Axel Carlson is a distinguished teaching professor emeritus in the Department of Biochemistry and Cell Biology at Stony Brook University.

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