Cocktails come in many colors, flavors, sizes, and smells, and are often decorated with various colorful garnishes, including tiny tiki umbrellas!
Besides the usual rum vodka, gin and tequila-based cocktails, there are many made from whiskey, brandy, and a multitude of liqueurs. And in some books, you might find cocktails (also nonalcoholic) made from wine and even beer.
Cocktails made from wine are perfect for hot weather, regardless of if you’re at the beach, pool, or just relaxing in a shaded area. They contain less alcohol than traditional cocktails and are great for entertaining.
Cocktails made with champagne, Prosecco, or other sparkling wines add a bit of festivity in every sip. I have chosen four Prosecco wines and four cocktail recipes for your enjoyment.
Corvezzo Prosecco “Extra Dry” DOC, Treviso (made from organic & vegan Glera and other grapes). Light yellow color with an aroma of brioche, pears, and celery. Clean with a flavor of honeydew, peaches, and apples.
2020 Corvezzo Prosecco “Rosé Extra Dry” DOC, Treviso (made from organic & vegan Glera and Pinot Noir grapes). Light strawberry color with an aroma and flavor of red fruits, berries, and tropical fruit. A lingering aftertaste of red apples and red licorice.
Gancia Prosecco “Brut” DOC, Veneto (Glera grapes). Straw yellow with green highlights. Delicate aroma and flavor of green apples and pears. Dry with a crisp, citrusy flavor and hints of honeysuckle and orange.
2020 Gancia Prosecco “Rosé Extra Dry” DOC, Veneto (blend of Glera and Pinot Noir grapes). Intense pink color with an aroma of raspberries, strawberries, and tropical fruit. Off-dry, with a clean, crisp flavor of pears and peaches.
Cocktail recipes
Pineapple Mimosa
1 ounce coconut rum
2 ounces pineapple juice
4 ounces Gancia Prosecco “Brut”
Put the first two ingredients into a cocktail shaker with ice. Shake and strain into a glass. Top with Prosecco, stir, and top with a pineapple slice and cherry.
Gin & Prosecco
1-1/2 ounces gin
3/4 ounce fresh lemon juice
1/2 ounce simple syrup (or agave)
3 ounces Corvezzo Prosecco “Rosé”
Put the first three ingredients into a cocktail shaker with ice. Shake and strain into a glass. Top with Prosecco, stir, and add a lemon twist.
Italian Cocktail
1-1/2 ounces Campari
5 ounces Corvezzo Prosecco “Extra Dry”
In tall glass, add Campari, then Prosecco and stir.
Rosé Prosecco With Strawberries
Fill a flat saucer champagne glass with sliced and hulled strawberries (about five). Pour 4 ounces of Gancia Prosecco “Rosé” over the strawberries. Top with sour cream and sprinkle with brown sugar.
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 www.boblipinski.com OR [email protected]
The son of my wife’s sister, my nephew, is older than I was when I met him.
It’s not so surprising, then, that he would be getting married, especially not after a long-term relationship that transitioned years ago from a matter of if to when in terms of marriage.
Still, it’s hard to imagine the next generation entering these milestone moments when I feel like my wife and I only recently got married, which clearly wasn’t such a recent event.
One of my first memories of my nephew, who was six years old when I babysat for his younger brother while he and his parents went to see “The Lion King” on Broadway, was of this enthusiastic child who wanted to participate in adult conversations.
On his way out the door, he promised to give me a thorough review of the show. While he was gone, his brother and I called my future wife. His younger brother pretended he was me and kept asking me what to say. Fortunately for him, my wife is as playful as he, and went along with the gag for a giggle-fest of a conversation.
A few years later, my sister-in-law told me she overheard her children discussing my marriage to their aunt. Her younger son was excited to add the title “uncle” to my name, while the older one wasn’t sure he wanted to call me “uncle.”
Not eager to stand on ceremony, I told him he could continue to call me “Dan,” although the uncle title quickly became a natural part of our interactions.
Over the years, I have reveled in his achievements, enjoyed hearing about his adventures, travels and jobs and have admired the joy he feels when he spends time with his fiancée.
He laughs, shares stories and dances with her at family parties.
With their wedding approaching in the next few days, it’s hard to believe that my wife and I will be members of the older generation.
Unlike my uncles and aunts, who attended my brother’s wedding in the summer and, generally, passed on my wedding in the winter, my wife and I have every intention of spending most of the wedding on the dance floor.
Yes, we’re older, and we likely won’t have the same modern dance moves that the next generation will likely display, but we love a great party and, what’s more, we love to celebrate life together.
As I did when we had a party for our daughter’s 16th birthday, I will likely sweat through my button down shirt and will probably drape my suit jacket over the back of the chair and won’t touch it until we’re clearing out the room.
At some point, someone with a video camera may come over to my wife and me, asking us to share our thoughts on this auspicious occasion.
I’m sure I will think about my antediluvian uncle, who was asked a similar question at my brother’s wedding.
After a long, reflective pause and with his customary flat affect, he looked directly into the camera. “It’s a sense o’ hyum’ah,” he suggested.
Listening to his wife whose voice cut through concrete as she exclaimed about everything from how much she loved my younger brother the best to how wonderful and delicious the food at any event was, I could see the importance of humor.
While my wife and I have reveled in making each other laugh, I don’t think I’ll repeat that line, even if it does apply, in part because it belongs to my uncle.
Instead, I may tell them to dance as often as they can and to enjoy the little moments, like the sound of a child’s laughter or the excited review of a Broadway show from a six-year-old.
Sitting at a bistro table on the sidewalk in Port Jefferson village this morning, sipping my coffee and people-watching, it occurred to me I could be anywhere enjoying such a scene. I was lingering on after a breakfast business meeting, and now alone, I relaxed with this thought. I could be in the many shoreline villages strung along the New England coast or any of the Atlantic fishing ports of the United States, or for that matter, those on the Pacific or the Gulf of Mexico. I could even be in Paris or Rome, although those are not portside locations.
That’s what summer will do to you. The warmth of the sun and the caressing breeze encourage daydreaming.
I saw residents walking their dogs, who, in turn, seemed more interested in what I was eating than in getting exercise. I greeted people I know, but haven’t seen in too long due to COVID, as they strolled by. A friend rolled down his window and waved on his drive up the block, calling out to me from the far lane to ask how I was. Customers at the next table started chatting with me and showing off their young baby, their first. The waitress came out to check on me and asked, “Can I get you anything more or would you just like to enjoy the moment?” Smart young woman, she understood.
We live in a wonderful place with many delightful offerings, but we probably don’t take the time to dwell on that fact. For example, even this past Thursday alone, we could have attended the opening night of the Stony Brook Film Festival, screening indie movies from throughout the world at the Staller Center on the campus of Stony Brook University. Or we might have tapped our feet and kept time with a performance at The Jazz Loft in Stony Brook village. The Huntington Summer Arts Festival has ongoing performances, this past Thursday featuring Lakecia Benjamin & Pursuance that started at 8 p.m. in Heckscher Park.
Also, on Thursday evening, there was the Smithtown Library concert, a lecture on the much-in-the-news sharks at the Whaling Museum in Cold Spring Harbor, a concert in the Show Mobile at Harborfront Park in the village of Port Jefferson, and in Northport Village Park the Northport Community Band continued its summer concert series. The Huntington Manor Fireman’s Fair, Long Island’s largest, started on Thursday at the Henry L. Stimson Middle School in Huntington Station.
And, as they say, so much more.
I’m not even mentioning the movie showings in the moonlight, the largesse of theaters, the art galleries, the farmers’ markets, the U-Pick opportunities, the wineries, the plethora of restaurants and opportunities for boutique shopping, and the glorious beaches to be enjoyed during the day and under the stars at night that are available at different times and days on our Island.
And try the local corn on the cob. This week it has been fabulous.
This may sound daffy to you, but when the weather becomes unbearably hot and humid, and I just want to get out on the water, I have even been known to ride the rear deck of the ferry to Bridgeport and back to Port Jefferson for a poor person’s afternoon cruise. And if you find yourself in need of a little exercise, walk the wooden pathway around Port Jefferson harbor, with or without your dog.
Next week is already August, and soon the summer will be gone, along with many of these attractions. While certainly others remain, we don’t have quite the leisure of mind to enjoy them that summer brings as the calendar turns.
Someone brought me a huge bag of pistachios last week and after shamelessly bingeing on them, I went on a quest to find other ways to use them. They had to be good, I thought,in a semifreddo recipe I had and would add a nice crunch to summer salads. I tried apesto with the pistachios instead of pignoli nuts and was very pleased and also made a pistachio-crusted salmon which was a big hit.
I still want to try them in crumbles as well as in a crust for fresh fruit pies and tarts and also pureed with cheeses or yogurt to make dips and spreads.
So, merrily snacking on the pistachios as I set to work, I did some homework and came up with these recipes. If you don’t like them, there’s always pistachio ice cream, everyone’s favorite, it seems, except mine.
Zabaglione and Pistachio Semifreddo
YIELD: Makes 8 servings
INGREDIENTS:
5 large egg yolks
3/4 cup sugar
3 tablespoons dry Marsala
3 large egg whites
3/4 cup heavy cream
3/4 cup chopped unsalted pistachios
DIRECTIONS:
Line a 9 x 5 x 3” loaf pan with plastic wrap; leave a 2” overhang on the top edges and chill the pan in the freezer. In the top of a double boiler beat together the egg yolk, 1/4 cup of the sugar and the Marsala until well blended. Place over simmering water and beat until the mixture has quadrupled in volume; remove from heat and place the bowl with the mixture in a larger bowl of ice water and, stirring occasionally, let cool.
In a large bowl beat egg whites until frothy, gradually add the remaining half cup of sugar and beat just until mixture holds soft peaks. In a large chilled bowl beat the cream until it holds soft peaks, gently but thoroughly fold in the egg whites; fold in the yolk mixture and then half a cup of the pistachios. Scrape mixture into prepared pan, cover with plastic wrap and freeze for at least 8 hours. Unmold the semifreddo onto a serving dish, sprinkle with remaining 1/4 cup pistachios; slice and serve with fresh raspberries and espresso.
Orecchiette with Pistachio and Basil Pesto
YIELD: Makes 6 servings
INGREDIENTS:
1 pound orecchiette pasta
1 cup shelled unsalted pistachios
1 cup basil leaves
1/2 cup extra virgin olive oil
1/4 – 1/3 cup freshly grated Parmigiano Reggiano cheese
3 garlic cloves
Salt and freshly ground pepper to taste
DIRECTIONS:
Bring a large pot of salted water to a boil; cook pasta according to package directions. Meanwhile in the bowl of a food processor combine the pistachios, basil, oil, cheese, garlic and salt and pepper; process, scraping sides of bowl often, until mixture reaches a smooth consistency. Reserving one cup of the cooking water from the pasta, drain it. In a large bowl, toss the pasta with the pesto, and add the reserved pasta water as needed to achieve the desired consistency. Serve hot or warm with a tomato salad and foccaccia.
Pistachio-Crusted Salmon
YIELD: Makes 8 servings
INGREDIENTS:
One 2 1/2 pound side salmon, skin on
Freshly squeezed juice of two lemons
1/4 cup prepared mustard
1 cup shelled unsalted pistachio nuts
1/2 cup unflavored bread crumbs
1/4 cup olive oil
1/2 cup chopped flat leaf parsley
Sea salt and freshly ground pepper to taste
DIRECTIONS:
Preheat oven to 350 F. Place salmon, skin side down, on a baking sheet. In a small bowl, combine lemon juice and mustard and brush lightly on top of salmon. In a food processor, combine the pistachios, bread crumbs, olive oil, parsley, salt and pepper. Sprinklemixture evenly over lemon and mustard mixture on salmon. Bake until salmon reaches desired doneness, about 15 to 20 minutes; remove to serving platter and let sit about 5 minutes. Serve with a tossed green salad or fresh asparagus.
Communities are held together by norms of civility and an overriding spirit of goodwill.
Right now those norms are withering away, supplanted by foul behavior and disrespect. In communities throughout this area, there has been an observable decline in civility, a dangerous trend that jeopardizes the community’s long-term prospects.
At Stony Brook University, members of the campus community have expressed growing concerns about the frequency of hostile encounters taking place in nearby communities. Students and staff members have become targets of scorn and prejudice, a phenomenon that should disturb our residents deeply.
In addition, elected officials and business owners are dismayed by the recent spike in vandalism and destruction of public and private property. Perhaps most alarmingly, police have investigated the July 5 burning of a sign at a Ronkonkoma mosque as a possible hate crime.
While destroying property and desecrating houses of worship surely violates several of our laws, these actions also tear at the fabric of our community. After two years of lockdowns and separation, community members now seem more estranged from one another than ever before.
The immediate consequence of all of this is that our community is less safe and less congenial than it once was. People will be less likely to spend their time and money in our local downtown areas, creating more vacant storefronts. But in the long run, people may soon flee this area in search of that community feeling that they couldn’t find here.
Since ancient antiquity, scholars have understood that people of a community cannot be held together by laws alone. Laws create a system of rules and keep communities orderly and regulated, but they cannot inspire neighborliness or tolerance. Aristotle contended that “friendship” was the necessary ingredient for a community to thrive.
We must cultivate the bonds of friendship that once existed among our community members. As citizens of this area, we must recognize that each person is entitled to our respect, regardless of religion, race, ethnic background or politics.
The people of Long Island are fortunate to have a superb public research institution right in their backyard, a place that offers jobs to our residents and a talented pool of students and staff who are eager to change the world for the better. We must welcome them as our own, deserving of our friendship and respect. We want them to stay right here on Long Island, where they can help us build upon and strengthen this community.
In a similar vein, we cannot tolerate the destruction of public or private property. Budgets are tight enough in our county, towns and villages, and taxpayers should not be forced to absorb these preventable costs. Moreover, small businesses are struggling enough amid nationwide economic challenges and the ongoing public health emergency. We should not compound their hardships and expenses either.
Progress requires a reassessment and realignment of our system of values. Let’s rediscover what it means to be civil and respectful to one another. Let’s foster that sense of civic friendliness and community cohesion that existed before. We must learn to respect our neighbors again, for without respect this community will not endure. As Aretha Franklin sang, “Just a little bit, a little respect.”
The last day of school has passed and summer is here. What better time to take advantage of travel with the family? And family for many of us includes four legged members.
Nowadays more and more hotels and rentals are pet friendly and, with a quick search on the internet, it can be easy to find establishments that accept pets. Camping is also a popular vacation choice and many campgrounds will accept pets.
Check with your veterinarian that your dog or cat is up to date on their vaccines, as well as discuss any additional vaccines against diseases that your pet may be at risk for when traveling (especially at campsites). Make sure you know where the nearest local veterinary emergency clinic or, in more rural areas, which veterinary clinic may offer emergency services.
What about travel itself? Some pets make excellent travel companions, while others don’t and become agitated in the car. Dogs or cats that become just mildly agitated in the car can get by with a more holistic approach.
One way to soothe our pet’s anxiety is to use scents. Lavender is an excellent way to calm dogs during travel induced excitement (one study used a lavender scented oil that could be sprayed on a blanket), whereas for cats a synthetic facial pheromone (scent hormone) is more effective.
Some pets are just too wound up to use any aromatherapy or pheromones and need medication. Certain sedatives or tranquilizers can be used for short to medium length trips, whereas medications such as selected serotonin reuptake inhibitors (SSRIs) or antidepressants are needed for really high-strung pets to take both during travel and a stay in an unfamiliar environment.
If you feel something like an SSRI or an antidepressant is warranted make sure to start well enough before leaving on vacation. Most of these medications have a four week induction period (meaning they are not truly at therapeutic levels for at least four weeks) and need to be weaned off after returning from vacation. Some pets also require pre medication bloodwork (to make sure our pet’s organs can safely tolerate the medication long term) so make an appointment well in advance of your vacation to see your veterinarian.
Antihistamines can be used for motion sickness but have been proven to make terrible sedatives for travel so check with your veterinarian before considering “self-medicating.” In conclusion, making our pets traveling guests can really enhance a vacation.Just travel safe.
Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.
Stony Brook Breast Cancer Screening mobile truck. (8/24/18)
By Daniel Dunaief
Some groups of people on Long Island have a much higher incidence of a particular type of cancer than others.
On an age adjusted rate, African American men, for example, were almost twice as likely to develop prostate cancer from 2014 to 2018 as Caucasians. Out of 100,000 African American men, 216.6 had prostate cancer compared with 123.9 out of 100,000 white men, according to data from the National Cancer Institute.
Dr. Linda Mermelstein. Photo from Stony Brook Medicine
Dr. Linda Mermelstein, Associate Director of Stony Brook Cancer Center’s Office for Community Outreach and Engagement, is working with her team to address those stark differences and to empower members of the community to protect their health and make informed decisions.
“A lot of our focus is on addressing disparities” in cancer care in various communities throughout Long Island, Dr. Mermelstein said.
The Cancer Center Outreach and Engagement office has taken numerous steps to inform the public about research and care. The center has a Mobile Mammography Unit, which travels into communities to provide access to screening for breast cancer.
On June 5, at the Latina Sisters Support Inc. Spanish Fair in Brentwood, the Cancer Center’s Community Outreach and Engagement staff provided mobile mammography screening and cancer prevention and screening education.
At that event, the Suffolk County Department of Health Services provided human papillomavirus and Covid-19 vaccines and Stony Brook School of Health Professionals offered blood pressure screening.
An information chasm
Dr. Jedan Phillips. Photo from Stony Brook Medicine
Dr. Jedan Phillips, Medical Director for Stony Brook Health Outreach and Medical Education and Associate Professor of Family, Population and Preventive Medicine at the Renaissance School of Medicine, explained that Covid-19 exposed the “chasm” between what the health care profession believed and the reality of what works and what doesn’t.
During the pandemic, Stony Brook University brought a vaccination pod to Uniondale in Nassau County, which is a predominantly African American community. “Because we had no relationship there, we might have wasted over 200 doses of the vaccine” as residents were reluctant to get vaccinated, he said. “Even though [Stony Brook] offered something that would help, people chose against it. It’s not about the vaccine. It’s something deeper.”
Dr. Phillips said East Elmhurst, Queens, where he grew up, was “ravaged by Covid. I know at least 10 people in my community who were regular figures in my life that died. I saw how vulnerable of a position we were in as a group and I felt I needed to get involved.”
Dr. Phillips, who has a family medical practice in East Patchogue, together with Dr. Yuri Jadotte, Assistant Professor and Associate Program Director for the Preventive Medicine Residency in the Department of Family, Population and Preventive Medicine at Stony Brook, created three focus groups to survey the views and understanding of African American men on prostate cancer.
Many African American men don’t get screened for prostate cancer, even though such screenings could lead to earlier treatment and better outcomes.
By listening to what inspires African American men throughout Long Island to take action, Dr. Phillips hopes to tailor information to that type of delivery.
“It’s important to listen and understand,” Dr. Phillips said. Understanding what motivates people and seeking to provide the formats in which they prefer to access information can help establish a community connection and demonstrate cultural compassion.
Part of Dr. Phillips’s focus on preventive medicine comes from his experience with his father, who died from complications related to diabetes. His father, who was an inspiration for him, “didn’t live life in a preventive way,” which made managing his health more difficult, Dr. Phillips said.
With the numerous programs offered by the Office for Community Outreach and Engagement, Dr. Mermelstein said the group has four primary goals.
Dr. Jedan Phillips provides medical care.
“We want to monitor and understand what is the cancer burden in our catchment area” which includes Nassau and Suffolk County, she said. “Much of our activities are identifying the issues in terms of cancer” and understanding any barriers towards cancer care, like education, screening, diagnosis and treatment.
Secondly, she wants to provide cancer prevention services, screening, education and community navigation. Third, the group has a bi-directional engagement, with researchers getting to know the community and community advocates and the community learning about the research process.
Finally, the group seeks to catalyze the research by focusing on disparities, providing research services to the entire community based on specific needs.
One of Dr. Mermelstein’s first actions after heading up this team in 2019 was to create a community advisory council for the Stony Brook Cancer Center.
Janine Logan, Vice President of Communications and Population Health with the Long Island Health Collaborative, serves on that advisory council.“What I’m most excited about is that the committee understands the importance of knowing what your community thinks and needs,” Logan said.
Logan is pleased with the work the Stony Brook Cancer Center has done to educate residents about the lifestyle behaviors that can contribute to cancer, such as smoking, inactivity, and nutrition.
“They’ve done a lot of work in reaching out and educating communities to help them understand that these simple, modifiable behaviors can reduce their risk” of developing cancer, Logan said.
The effort at the Cancer Center to educate the public about the danger’s of the sun dovetails with some of the work she has done at the Long Island Health Collaborative.
Indeed, the Cancer Center Community Outreach and Engagement hosted a “Block the sun, not the fun” gathering on May 7 at the Smith Haven Mall in Lake Grove.
The Stony Brook Cancer Center is also working with the Suffolk County Department of Health Services Cancer Prevention and Health Promotion Coalition to provide information about sunscreen safety.
In addition to the disparity among African American men who develop prostate cancer, the outreach effort also addressed the difference among hispanic women who have a higher incidence of cervical cancer than the non-hispanic Caucasian population.
In Suffolk County, about 10.2 Hispanic and Latino women out of 100,000 Hispanic and Latino women develop cervical cancer, which is higher than the 5.9 per 100,000 for white, non-Hispanic women, according to the National Cancer Institute.
Human papillomarvirus is estimated to cause about 36,500 cases of cancer in men and women every year in the United States. The HPV vaccination, which works best before exposure to the virus, can prevent 33,700 of those cancers. Because the vaccine doesn’t prevent all cancers, women still need screening to protect themselves.
Previously employed for 22 years with the Suffolk County Department of Health Services, Dr. Mermelstein, who has a medical degree and a master’s in public health, briefly retired, before taking this job at Stony Brook.
“I wanted to do something to help address cancer after I retired, and so I contacted Stony Brook Cancer Center and began in this position about four months after I retired,” she explained.
Those interested in reaching out to the Office for Community Outreach and Engagement can call 631-444-4263 or email [email protected].
In last month’s column, I wrote about how the real estate market experiences its ups and downs. A few current trends are an example of how true that is.
Mortgage rates
While mortgage rates dropped half a percent the week ending July 7, they shifted slightly back up the following week to 5.51% for a 30-year fixed mortgage.
Keep in mind that the rates we have been seeing are still historically low, even with experts forecasting that the Federal Reserve will boost rates by ¾ of a percentage point at its next meeting.
Some financial experts believe we are headed toward a recession, and you may wonder what happens to interest rates in that scenario. Due to fewer people taking out loans, banks may offer interest rate programs to incentivize people. Currently, interest rates are still very low and can be locked in.
Inventory trend
After an extended seller’s market, there still isn’t enough inventory to keep up with the demand. Keep an eye on mortgage rates, though. Some may decide not to buy or sell, thinking they’ll get a better deal by waiting. This may not be the best decision for buyers or sellers and may also lead to an inventory increase.
Experts are now forecasting that the increase will be more than 9% by the end of 2022, which means more competition. This increase will not occur instantaneously; it will take some time. Get that For Sale sign up before your neighbor does.
Foreclosures may play a factor in inventory increases, too. The COVID-19 Eviction and Foreclosures Act of 2020 enacted a moratorium until Jan.15, 2022.
While experts are seeing a steady climb in foreclosures throughout the country, the ATTOM U.S. Foreclosure Market Report shows New York’s foreclosures are 13.3% less than the same period in 2020. It’s a trend to keep an eye on as the more houses foreclosed on, the more properties are available to buyers.
Another factor is the federal act helped slow down foreclosures during a time when homes were appreciating. For some who were about to default on their mortgages before the moratorium, they can now sell their homes for more money and pay off what they owed.
To touch on appreciation, according to a One Key MLS report, median sales prices in Suffolk County showed a nearly 11% increase from June 2021 to June 2022.
Here’s more good news for Suffolk County. In the last few months, the majority of homes were still selling in less than a month and about 23% quicker than they did last year during the same period.
Pricing
It’s all about pricing. When talking to a real estate professional, they should discuss current market factors, as well as details of your home, and help you price it accordingly. Also, proper pricing will enable you to sell your home to your timing and pricing expectations.
Takeaway
There are many moving pieces regarding how well a person will do when selling or buying a home. Considering buying your first home, downsizing, moving into a bigger place or to another state before the end of the year, now is the time to discuss your plans with a real estate professional. So … let’s talk.
Michael Ardolino is the Founder/Owner-Broker of Realty Connect USA.
It is very important to stay hydrated and drink plenty of fluids, especially if you have a history of stone formation. METRO photo
Once you’ve had one stone, your risk for others increases
By David Dunaief, M.D.
Dr. David Dunaief
Kidney stones can have no symptoms, but more often they present with the classic symptoms of blood in the urine and colicky pain. This pain can be intermittent or constant, and it can range from dull to extremely painful, described by some as being worse than giving birth, shot or burned. The pain may radiate from the kidneys to the bladder and even to the groin in males, depending on the obstruction (1).
Stones are usually diagnosed through the symptoms and either abdominal x-rays or non-contrast CT scans.
Unfortunately, the first line treatment for passing kidney stones — at least small ones — involves supportive care. This means that patients are given pain medications and plenty of fluids until the stone(s) pass. Usually stones that are <4mm pass spontaneously. Location is an important factor as well, with stones closest to the opening of the urethra more likely to pass (2).
Generally, if you’ve passed a kidney stone, you know it. In the case of a stone too large to pass naturally, a urologist may use surgery, ultrasound, or a combination of methods to break it into smaller pieces, so it can be passed.
Unfortunately, once a patient forms one stone, the incidence of others increases significantly over time. The good news is that there are several lifestyle changes you can make to reduce your risk.
Hydrate, hydrate, hydrate
First, it is very important to stay hydrated and drink plenty of fluids, especially if you have a history of stone formation (3). You don’t have to rely on drinking lots of water to accomplish this. Increasing your consumption of fruits and vegetables that are moisture-filled can help, as well.
Calcium from diet vs. supplements
One of the simplest methods is to reduce your intake of calcium supplements, including foods fortified with calcium. There are two types of stones. Calcium oxalate is the dominant one, occurring approximately 80 percent of the time (4). Calcium supplements, therefore, increase the risk of kidney stones. When physicians started treating women for osteoporosis with calcium supplements, the rate of kidney stones increased by 37 percent (5). According to findings from the Nurses’ Health Study, those who consumed highest amount of supplemental calcium were 20 percent more likely to have kidney stones than those who consumed the lowest amount (6). It did not matter whether participants were taking calcium citrate or calcium carbonate supplements.
Interestingly, calcium from dietary sources actually has the opposite effect, decreasing risk. In the same study, those participants who consumed the highest amount of dietary calcium had a 35 percent reduction in risk, compared to those who were in the lowest group. Calcium intake should not be too low, for that also increases kidney stone risk. Changing your source of calcium is an important key to preventing kidney stones.
Watch your sodium intake
It’s important to reduce sodium for many reasons, but we’ll provide one more here. Again, in the Nurses’ Health Study, participants who consumed 4.5 g sodium per day had a 30 percent higher risk of kidney stones than those who consumed 1.5 g per day (6). The reason is that increased sodium causes increased urinary excretion of calcium. When there is more calcium going through the kidneys, there is a higher chance of stones.
Limit animal protein
Animal protein also may play a role. In a five-year, randomized clinical trial, men who reduced their consumption of animal protein to approximately two ounces per day, as well as lowering their sodium, were 51 percent less likely to experience a kidney stone than those who consumed a low-calcium diet (7). These were men who had a history of stone formation. The reason animal protein may increase the risk of calcium oxalate stones more than vegetable protein is that animal protein’s higher sulfur content produces more acid. This acid is neutralized by release of calcium from the bone (8). That calcium can then promote kidney stones.
Reverse blood pressure naturally
Some medical conditions may increase the likelihood of stone formation. For example, in a cross-sectional study with Italian men, those with high blood pressure had a two times greater risk of kidney stones than those who had a normal blood pressure (9). Amazingly, it did not matter whether or not the patients were treated for high blood pressure with medications; the risk remained. This is just one more reason to treat the underlying cause of blood pressure, not just the symptoms.
The most productive way to avoid the potentially excruciating experience of kidney stones is to make these relatively simple lifestyle changes. The more changes that you implement, the lower your likelihood of stones.
References:
(1) emedicine January 1, 2008. (2) J Urol. 2006;175(2):575. (3) J Urol. 1996;155(3):839. (4) N Engl J Med. 2004;350(7):684. (5) Kidney Int 2003;63:1817–23. (6) Ann Intern Med. 1997;126(7):497-504. (7) N Engl J Med. 2002 Jan 10;346(2):77-84. (8) J Clin Endocrinol Metab. 1988;66(1):140. (9) BMJ. 1990;300(6734):1234.
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.
This week’s featured shelter pets are Rosie (tortoise shell) and Tabitha (calico), who ended up at the Smithtown Animal Shelter after their mom passed away.
Tabitha
These beauties are 12-13 years young sisters. While they enjoy each other, they are not bonded. The shelter would love to see them go together but won’t require it.
Rosie is outgoing and affectionate with absolutely anyone she meets.Tabitha is still a bit shell shocked at the transition from her quiet home to the shelter and has been a bit withdrawn. They have never lived with dogs, but have lived with threeother cats. Rosie would do well in any home while Tabitha would do best in a quieter home.
The Smithtown Animal & Adoption Shelter is located at 410 Middle Country Road, Smithtown. Visitor hours are currently 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 or visit www.townofsmithtownanimalshelter.com.
Cocktail recipes
We live in a wonderful place with many delightful offerings, but we probably don’t take the time to dwell on that fact. For example, even this past Thursday alone, we could have attended the opening night of the Stony Brook Film Festival, screening indie movies from throughout the world at the Staller Center on the campus of Stony Brook University. Or we might have tapped our feet and kept time with a performance at The Jazz Loft in Stony Brook village. The Huntington Summer Arts Festival has ongoing performances, this past Thursday featuring Lakecia Benjamin & Pursuance that started at 8 p.m. in Heckscher Park.
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