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Taking calcium may only help if you’re deficient

By David M. Dunaief, M.D.

Dr. David Dunaief

We should all be concerned about osteoporosis risk. According to the Bone Health & Osteoporosis Foundation, 50 percent of women and 25 percent of men will break at least one bone due to osteoporosis (1). Hip fractures are especially concerning, because they increase mortality risk dramatically. More than 50 percent of hip fracture survivors are no longer able to live independently (2).

Do we need to consume more dairy?

Studies suggest that milk and other dairy products may not be as beneficial as we have been raised to believe.

Studies have shown milk may not be beneficial for preventing osteoporotic fractures. Specifically, in a meta-analysis that used data from the Nurses’ Health Study for women and the Health Professionals Follow-up Study for men, neither men nor women saw any benefit from milk consumption in preventing hip fractures (3).

In a 2020 meta-analysis of several past studies, researchers concluded that increased consumption of milk and other dairy products did not lower osteoporosis and hip fracture risks (4).

Generally, studies suggest that dairy may cause additional health problems. The results of a large, 20-year, observational study involving men and women in Sweden showed that milk may be harmful (5). When comparing those who consumed three or more cups of milk daily to those who consumed less than one, there was a 93 percent increased risk of mortality in women between the ages of 39 and 74. 

Dosage also mattered. For every one glass of milk consumed, there was a 15 percent increased risk of death for women. There was a much smaller, but significant, three percent per glass increased risk of death in men. For both women and men, researchers found biomarkers in the urine that indicated higher levels of oxidative stress and inflammation.

Remember: these are only associations, not decisive conclusions. The researchers surmise that milk has high levels of D-galactose, a simple sugar that may increase inflammation.

Interestingly, the USDA recommends that, from the age of 9 through adulthood, we consume about three cups of dairy per day (6).

Should we take calcium supplements?

We know calcium is a required element for strong bones, but do supplements really prevent osteoporosis and subsequent fractures? While the data are mixed, it suggests supplements may not be the answer for those who are not calcium deficient.

In a meta-analysis involving a group of observational studies, there was no statistically significant improvement in hip fracture risk in those men or women ingesting at least 300 mg of calcium from supplements and/or food daily (7).

The researchers did not differentiate among the types of foods containing calcium. In a group of randomized controlled trials analyzed in the same study, those taking 800 to 1,600 mg of calcium supplements per day also saw no increased benefit in reducing nonvertebral fractures. In four clinical trials, the researchers saw an increase in hip fractures among those who took calcium supplements. A weakness of this large study is that vitamin D baseline levels, exercise and phosphate levels were not considered in the analysis.

Does vitamin D supplementation reduce risk?

Finally, though the data are not always consistent for vitamin D, it appears it may be valuable when it comes to fracture prevention. In a meta-analysis involving 11 randomized controlled trials, vitamin D supplementation resulted in fewer fractures (8). When patients were given a median dose of 800 IUs (ranging from 792 to 2,000 IUs) of vitamin D daily, those who were aged 65 and over experienced a 14 percent reduction in nonvertebral fractures and an even greater 30 percent reduction in hip fractures. However, vitamin D in lower levels did not significantly reduce fracture risk.

Where does that leave us?

Our knowledge of dietary approaches is continually evolving. Dairy’s role may be an example of this. No definitive statement can be made about calcium, although even in randomized controlled trials with supplements, there was no significant benefit. However, the patients in these trials were not necessarily deficient in calcium nor vitamin D.

To prevent fracture, older patients may need at least 800 IUs of vitamin D supplementation per day.

Remember that treatment and prevention approaches should be individualized, and deficiencies in vitamin D or calcium should usually be treated, of course. Please, talk to your doctor before adding or changing any supplements.

References: 

(1) www.bonehealthandosteoporosis.org. (2) EndocrinePractice. 2020 May;26(supp 1):1-46. (3) JAMA Pediatr. 2014;168(1):54-60. (4) Crit Rev Food Sci Nutr. 2020;60(10):1722-1737. (5) BMJ 2014;349:g6015. (6) health.gov. (7) Am J Clin Nutr. 2007 Dec;86(6):1780-1790. (8) N Engl J Med. 2012 Aug. 2;367(5):481.

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.

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Photo from Stony Brook University Hospital

Stony Brook University Hospital (SBUH) has been named one of the Top 25 Hospitals in the country for its work pursuing environmental excellence. Based on a rigorous scoring system, this award honors success and performance in a range of sustainability programs including leadership, waste, chemicals, greening the operating room, food, sustainable procurement, energy, water, climate, transportation, and green building. As Practice Greenhealth’s highest honor for the Partner for Change application, this award recognizes the best of the best in health care environmental sustainability.

Additionally, SBUH’s multi-disciplinary efforts on reducing its environmental footprint in various impact areas have resulted in earning the recognition of Circles of Excellence in Chemicals, Sustainable Procurement, Energy, and Green Building. The Circles of Excellence Awards honor the 10 highest-performing hospitals in each area of sustainability impact.

“Our sustainability successes come from many passionate employees working to make our hospital a leader in providing world class healthcare, while ensuring our resources are used efficiently to minimize our impact on the environment,” said Carol Gomes, MS, FACHE, CPHQ, Chief Executive Officer, Stony Brook University Hospital. “I’m incredibly proud of the Stony Brook Medicine faculty and staff for their continued dedication and hard work in advancing environmental excellence within healthcare.”

Some of the Hospital’s successes over the last year include:

  • Significant reductions in our use of the anesthetic desflurane
  • Significant reductions in regulated medical waste generation
  • Expansion of our reprocessing and sustainable purchasing programs
  • Reduction in total waste per patient day
  • Expansion of the impact of our Food Farmacy program and our Stony Brook Heights micro-farm that distributes food to food-insecure community members
  • Elimination of the central nitrous oxide system at Ambulatory Surgery Center
  • Several physical plant and capital projects that reduce our energy use, including the very visible Curtain Wall project and less visible infrastructure projects.

Practice Greenhealth is the leading sustainable health care organization, delivering environmental solutions to more than 1,700 hospitals and health systems in the United States and Canada.

To learn more about Stony Brook Medicine’s sustainability efforts, visit stonybrookmedicine.edu/sustainability.

 

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With the Medical Aid in Dying Act having passed both houses of the New York State Legislature, Cona Elder Law will host a free webinar titled “End-of-Life Conversations: Tools for Dignity, Clarity, and Comfort” on Wednesday, June 18 at 9 a.m.

The webinar will be hosted by Jennifer B. Cona, founder and managing partner of Cona Elder Law and Melissa Negrin-Wiener, Esq., Senior Partner, Cona Elder Law.

The Medical Aid in Dying Act (S.138/A.136) would allow mentally competent, terminally ill adults with six months or less to live to request life-ending medication. The bill passed the New York State Assembly and Senate and now awaits signature by Governor Hochul. If signed, New York would become the 12th state to legalize medical aid in dying.

While the legislation has generated both support and criticism, it has also sparked a vital conversation about how individuals and families approach end-of-life decisions.

“This is a critical topic for our clients and their loved ones,” said Jennifer B. Cona, founder and managing partner of Cona Elder Law. “We have daily conversations regarding living with dignity, safeguarding choice of care and living arrangements, end-of-life care, and ensuring wishes are followed, both as to healthcare as well as asset distribution. This law is another tool in the toolbox for ensuring dignity, control, and a life worth living defined by one’s own terms.”

The webinar will provide:

  • Guidance on initiating end-of-life care conversations
  • Legal tools such as health care proxies and living wills
  • Strategies for aligning personal values with medical decisions
  • What the community needs to know about the new law
  • A forum for questions about the current legal landscape

The event is free and open to the public. Registration is available here.

About Cona Elder Law

Cona Elder Law concentrates in the areas of elder law, estate planning, estate administration and litigation, and health care law. Cona Elder Law takes a holistic approach to elder law, providing support and resources for older adults and caregivers, and maintains long-term, partnering relationships with clients to provide the best solutions for multiple generations.

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Photo from SCWA

The Suffolk County Water Authority announced on June 10 that all treated water it supplies to customers is in full compliance with the federal drinking water standards for PFOA and PFOS—six years ahead of the 2031 compliance deadline set by the U.S. Environmental Protection Agency (EPA).

The EPA finalized a new enforceable standard of 4 parts per trillion (PPT) for both PFOA and PFOS in April 2024. SCWA’s testing this past April confirmed that no treated water in its system contained PFOA or PFOS above that level. This achievement comes despite the widespread presence of PFAS in Long Island’s aquifer.

“Given the extent of PFAS detections across Long Island and the size of our system, this is a historic achievement,” said SCWA Chairman Charles Lefkowitz. “This result shows that with the right investment and urgency, we can stay ahead of emerging threats to public health.”

PFAS, or per- and polyfluoroalkyl substances, are a class of synthetic chemicals that have been widely used for decades in products such as non-stick cookware, stain-resistant fabrics, food packaging and firefighting foams. These substances do not break down easily and have leached into groundwater in many areas, including Long Island. Long-term exposure to certain PFAS compounds—particularly PFOA and PFOS—has been linked to health effects including developmental issues, hormone disruption and certain cancers.

To meet the new federal standards well ahead of schedule, SCWA installed 17 granular activated carbon (GAC) treatment systems for PFAS in the past year alone. GAC filters remove PFAS by adsorbing the contaminants onto specially prepared carbon. Water is passed through these large vessels, and the PFAS compounds adhere to the carbon, allowing clean water to continue through the system. Testing by SCWA shows that GAC removes PFAS compounds to non-detectable levels.

“This didn’t happen overnight,” said SCWA Chief Executive Officer Jeff Szabo. “We’ve been working for years to build a treatment program that protects our customers and anticipates regulatory changes. The fact that we’re already in compliance—years ahead of the federal deadline—speaks to the expertise of our team.”

 SCWA continues to test regularly and will immediately remove any well from service if it detects PFOA or PFOS above 4 PPT if that well does not already have treatment in place. SCWA’s long-term goal is to supply water without any detectable levels of PFAS compounds, and additional treatment systems are planned for installation.

“This is about protecting public health,” said Suffolk County Executive Ed Romaine (R). “I want to thank the Suffolk County Water Authority for acting early and doing what’s necessary to provide residents with some of the cleanest drinking water in the country. Their leadership and investment in treatment technology are making a real difference.”

“Ensuring public safety and preserving our water quality are two of the highest priorities for me and my legislative colleagues. The leadership of the Suffolk County Water Authority has again shown its commitment to protecting the public, and in this case has exceeded expectations set by the federal government in achieving safer, even zero levels, of PFAS compounds in our water,” said Presiding Office Kevin J. McCaffrey.

“Clean drinking water is essential to public health, and PFAS contamination is a serious threat that demands action,” said Adrienne Esposito, Executive Director of Citizens Campaign for the Environment. “Meeting the federal standards well ahead of schedule is a positive step forward in safeguarding Suffolk’s residents.”

SCWA’s accelerated timeline has been supported in part by $16 million in grant funding awarded by New York State. These funds have helped offset the significant cost of installing advanced PFAS treatment systems, allowing SCWA to move faster while minimizing the financial impact on customers. By leveraging state support and working efficiently, SCWA has been able to continue delivering high-quality water at some of the lowest rates in New York.

“This is one of the largest groundwater systems in the country—and one of the most complex,” Lefkowitz added. “We’ve proven that even in a region with serious PFAS challenges, we can deliver water that meets the highest health standards.”

SCWA is an independent public-benefit corporation operating under the authority of the Public Authorities Law of the State of New York. Serving approximately 1.2 million Suffolk County residents, the Authority operates without taxing power on a not-for-profit basis.

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Distinguished Professor Arie Kaufman demonstrating two applications in the FlexiCAVE. On the left is a protein volume (inner pivot ~10 degrees, outer pivot ~30 degrees), and on the right side is Submerse application – visualization for extreme weather flooding in urban environments (on a flat FlexiCAVE section). Photo from SBU

Technology Can Be Used in Multiple Areas Including Healthcare, Climate Change, Managing Natural Disasters, Architecture, Urban Planning and Drug Design

Stony Brook University’s Center for Visual Computing has completed construction of the FlexiCAVE—the world’s largest flexible, dynamically reconfigurable high-resolution stereo display facility. Housed on the first floor of the New Computer Science (NCS) building, the FlexiCAVE comprises 40 tiled, high-pixel-density monitors capable of rendering about 83 million pixels, all while physically transforming its shape to support a wide range of scientific and data-driven applications, improving  immersive visualization technology.

“We envisioned a display that would adapt to the data—not the other way around,” said Arie Kaufman, distinguished professor of Computer Science and the principal investigator behind the project. “With FlexiCAVE, we’re enabling researchers to literally shape their workspace to the needs of their analysis.”

Innovative Interaction and Applications

Unlike traditional static visualization walls or even curved displays, the FlexiCAVE is built on a modular architecture with rotatable display columns. The system can seamlessly transition between flat, L-shaped, U-shaped, or semi-circular configurations in real time. These transitions are not only cosmetic.  They directly influence the visualization, the user experience and the type of data interaction enabled.

A custom-built rendering engine powers the design that synchronizes stereo views and dynamically updates visualizations as users physically adjust the screen layout. The team calls this new interaction paradigm —PIVoT, which is an acronym for  Physical Interaction to Virtual Transformation.

“It’s more than a screen. It’s a physical and tangible interface for virtual exploration where users are immersed in the data, and the layout of the FlexiCAVE anchors their sense of whereness, helping them stay oriented as they navigate complex visual spaces,” noted Principal Research Scientist Dr. Saeed Boorboor, co-author of the recently submitted VIS 2025 paper which details the system.

Real-World Applications

Immersive virtual colonoscopy showing on the FlexiCAVE, where radiologists navigate inside the patient’s colon model to locate and analyze polyps (all pivot angles are ~40 degrees). Photo from SBU

The team has already demonstrated real-world applications in many areas including healthcare. For example, virtual colonoscopy shifts the layout from a flat 2D overview of the patient’s colon to a curved immersive 3D endoluminal view (see Figure 2). In medical imaging visualization, radiologists can tangibly move the FlexiCAVE displays to virtually “slice” through brain MRI or abdominal CT scans.

And in situations like in  urban flood simulations, emergency planners can  orient and navigate flooding scenarios spatially by reconfiguring the display (see Figure 1).

In addition, researchers are using FlexiCAVE to experiment with multivariate data visualization, dynamically switching between scatter plots and parallel coordinate plots by physically bending screen segments. This hands-on interaction transforms the way users explore complex datasets. In an early user study, participants preferred the flexibility of the system and reported improved spatial perception over traditional static layouts. Other areas that can be enhanced  include architecture, urban planning, geospatial data, biological systems, drug design, and many others.

Why Now?

As datasets continue to grow in both size and complexity—ranging from volumetric brain scans to climate models—there is a pressing need for immersive tools that allow researchers to explore data from multiple angles and scales. The FlexiCAVE, part of a  growing trend in large high-resolution tiled displays,takes a bold step forward by combining stereoscopy, dynamic curvature, and tangible interaction into one unified system.

With backing from the New York State and Federal agencies, the FlexiCAVE’s development represents years of engineering insight, including customized aluminum framing, inclinometer-equipped hinges, and powerful GPU clusters capable of real-time image updates in a noise-canceling cabinet.

Looking Ahead

While the current version requires manual adjustment of the display columns—a design challenge acknowledged by the team—future updates may introduce motorized column rotation for ease of use. The research group is also exploring new applications in collaborative analytics and adaptable visualization workflows.

“We hope FlexiCAVE becomes a blueprint for the next generation of immersive environments—not only here at Stony Brook, but also globally,” said Professor Kaufman.

 

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Mather Hospital
Harshini Devi Sobhan. Photo from Mather Hospital

Mather Hospital in Port Jefferson has expanded its Graduate Medical Education program with the addition of a PGY1 Pharmacy Residency program, starting on July 1, 2025. The Pharmacy Residency is a 12-month program that “aims to cultivate clinical, operational and leadership skills in pharmacists, all while delivering high-quality pharmaceutical care to patients,” according to a press release.

As licensed pharmacists the residents will participate in activities designed to deepen their knowledge of regulatory compliance, pharmacotherapy, medication safety, antibiotic stewardship, committee participation, and key pharmacy initiatives. The program provides residents with the opportunity to advance and strengthen their professional development, emerge as skilled practitioners, and prepare for PGY2 specialty training and board certification. 

“Our Pharmacy Department has long been dedicated to delivering exceptional, patient-centered care. Through the establishment of the pharmacy residency program, we reaffirm our commitment to preparing pharmacists to uphold elevated standards of practice,” read the release.

Allison Nicole Pollina. Photo from Mather Hospital

Program Director Maricelle Monteagudo-Chu, PharmD, said the pharmacy residents will be an invaluable addition to the team. “They will be entrusted with managing patients with complex disease states, a responsibility that requires a higher level of critical thinking and advanced clinical knowledge. They will also actively collaborate with physicians and other healthcare professionals to improve patient outcomes, ensure the safe and effective use of medications, and advance excellence in pharmaceutical care,” she said.

To kick off the inaugural year, the first two residents will be Allison Nicole Pollina and Harshini Devi Sobhan, who both completed their Doctor of Pharmacy degrees from the University of Rhode Island College of Pharmacy and Touro College of Pharmacy, respectively. Sobhan also received her Bachelor of Science in Biology from City University of New York, York College and a Master of Science in Health Sciences and Public Health from Touro University Worldwide.

Mather Hospital’s Graduate Medical Residency Program was established in 2014 to address a growing shortage of physicians in our community and an increasing demand for primary care physicians. The program now includes more than 110 residents in Internal Medicine, Diagnostic Radiology, Integrated Interventional Radiology, Psychiatry, and Transitional Year as well as fellowships in Gastroenterology and Hematology Oncology. 

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Fiber-rich foods, including whole grains, seeds and legumes, as well as some beverages, such as coffee and wine, contain measurable amounts of lignans. Stock photo
Ozempic/Mounjaro don’t substitute for lifestyle changes

By David Dunaief, M.D.

Dr. David Dunaief

Type 2 diabetes management knowledge is always evolving. Here, we will examine how some diabetes management myths hold up against recent research.

Myth: Fruit can raise your sugars

Diabetes patients are often advised to limit whole, juiced, and dried fruit, because it can raise your sugars. This is only partly true. 

Yes, you should avoid fruit juice and dried fruit, because they do raise or spike glucose (sugar) levels. This includes dates, raisins, and apple juice, which are often added to “no sugar” packaged foods to sweeten them.

This is not true for whole fruit, which can be fresh or frozen. Studies have shown that patients with diabetes don’t experience sugar level spikes from whole fruit, even when they consume them in abundance (1). Another study showed that consuming whole fruit reduces type 2 diabetes risk (2).

In a third study, researchers considered the impacts of different types of whole fruits on glucose levels. They found that berries reduced glucose levels the most, but even bananas and grapes reduced these levels (3). The only fruit tested that seemed to have a mildly negative impact on sugars was cantaloupe.

Whole fruit is not synonymous with sugar. One reason for the beneficial effect is the fruits’ flavonoids, or plant micronutrients, but another is their fiber.

Myth: You should avoid all carbohydrates

Fiber is one type of carbohydrate that has important benefits. It can reduce risks for an array of diseases and improve outcomes. This holds true for type 2 diabetes risk. 

Two very large prospective observational studies, the Nurses’ Health Study (NHS) and NHS II, showed that plant fiber helped reduce the risk of type 2 diabetes (4). 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 when compared to the control group without diabetes. There was a direct relationship between the level of metabolites and the reduction in diabetes risk: the more they consumed and the more metabolites in their urine, the lower the risk. The authors encourage patients to eat a plant-based diet to get this benefit.

Foods with lignans include cruciferous vegetables, such as broccoli and cauliflower; an assortment of fruits and whole grains; flaxseed; and sesame seeds (5). The researchers could not determine which plants contributed the greatest benefit; however, they believe antioxidant activity drives this effect.

Myth: You should avoid soy

In diabetes patients with nephropathy (kidney damage or disease), consuming soy has been associated with kidney function improvements (6). There were significant reductions in urinary creatinine levels and proteinuria (protein in the urine), both signs that the kidneys are functioning better.

This was a four-year, small, randomized control trial with 41 participants. The control group’s diet included 70 percent animal protein and 30 percent vegetable protein, while the treatment group’s diet consisted of 35 percent animal protein, 35 percent textured soy protein and 30 percent vegetable protein.

This is important, since diabetes patients are 20 to 40 times more likely to develop nephropathy than those without diabetes (7). It appears that soy protein may put substantially less stress on the kidneys than animal protein. However, those who have hypothyroidism and low iodine levels should be cautious about soy consumption; some studies suggest it might interfere with synthetic thyroid medications’ effectiveness (8).

Myth: Ozempic/Mounjaro helps with weight loss

One of the latest entrants in diabetes sugar-control/weight loss pursuit is GLP-1 receptor agonists, including tirzepatide (Mounjaro/Zepbound) and semaglutide (Ozempic/Wegovy). They have a primary focus on glucose control and a secondary effect of weight loss. It sounds like a dream, right? Unfortunately, it’s not that simple. It’s important to recognize that the phase III clinical trial of these drugs’ weight loss capabilities actually excluded patients with diabetes (9). While the trials did measure lean body mass at different points and doses, they did not report muscle loss.

In clinical use since their approval, further studies have found patients can lose significant muscle mass during treatment. Quoted numbers range between 10 and 25 percent muscle loss (10, 11). In my practice, I have seen an average of 50 percent muscle loss. Because of this tendency, those taking tirzepatide and semaglutide need to make lifestyle changes to offset this, including weight training and diet.

We still have a lot to learn with diabetes, but our understanding of how to manage lifestyle modifications is becoming clearer. Emphasizing a plant-based diet focused on whole fruits, vegetables, beans and legumes can improve your outcomes. 

If you choose a medical approach, you still need to make significant lifestyle changes to overcome its risks.

References: 

(1) Nutr J. 2013 Mar. 5;12:29. (2) Am J Clin Nutr. 2012 Apr.;95:925-933. (3) BMJ online 2013 Aug. 29. (4) Diabetes Care. online 2014 Feb. 18. (5) Br J Nutr. 2005;93:393–402. (6) Diabetes Care. 2008;31:648-654. (7) N Engl J Med. 1993;328:1676–1685. (8) Thyroid. 2006 Mar;16(3):249-58. (9) N Engl J Med 2022;387:205-216. (10) AACE Clin Case Reports. 2025 Mar-Apr.;11(2):98-101. (11) Diabetes, Obesity and Metabolism. 2025 May. 27(5): 2720-2729.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management.

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Kidney health. METRO photo
Regular screening for CKD can help identify early stage kidney disease

By David Dunaief, M.D.

Dr. David Dunaief

In last week’s article about chronic kidney disease (CKD), we learned that roughly 90 percent of U.S. adults who have CKD are not even aware they have it (1). How can this be?

CKD can be asymptomatic in its early stages. Once it reaches moderate stages, vague symptoms like fatigue, malaise and loss of appetite typically surface. When CKD reaches advanced stages, symptoms become more obvious and troublesome.

Your kidneys are basically blood filters. They remove waste, toxins, and excess fluid from your body. They also play roles in controlling your blood pressure, producing red blood cells, maintaining bone health, and regulating natural chemicals in your blood.

When your kidneys aren’t operating at full capacity, you can experience heart disease, stroke, anemia, infection, and depression – among others.

When should you be screened for CKD?

Those at highest risk for CKD include patients with diabetes, high blood pressure and those with first-degree relatives who have advanced disease.

If you have diabetes, you should have your kidney function checked annually (2). If you have other risk factors, like high blood pressure, heart disease, or a family history of kidney failure, talk to your physician about establishing a regular screening schedule.

A 2023 study by Stanford School of Medicine recommends screening all U.S. adults over age 35. The authors conclude that the costs for screening and early treatment are lower than the long-term cost of treatment for those who are undiagnosed until they have advanced CKD (3). They also project that early screening and treatment will improve life expectancy.

How can you protect your kidneys?

Walking regularly and reducing protein and sodium consumption can help. One study shows that walking reduces the risk of death by 33 percent and the need for dialysis by 21 percent (4). Those who walked more often saw better results: participants who walked one or two times a week had a 17 percent reduction in death and a 19 percent reduction in kidney replacement therapy, while those who walked at least seven times per week experienced a 59 percent reduction in death and a 44 percent reduction in the risk of dialysis. The study included 6,363 participants with an average age of 70 who were followed for an average of 1.3 years.

With CKD, more dietary protein may be harmful. In a meta-analysis of 17 studies of non-diabetic CKD patients who were not on dialysis, results showed that the risk of progression to end-stage kidney disease, including the need for dialysis or a kidney transplant, was reduced 36 percent in those who consumed a very low-protein diet, rather than a low-protein or a normal protein diet (5).

How much sodium is too much? Results of one study showed that modest sodium reduction in our diet may be sufficient to help prevent proteinuria (protein in the urine) (6). Here, less than 2000 mg per day was shown to be beneficial.

What role do high blood pressure medications play?

Certain medications, ACE inhibitors or ARBs, are regularly prescribed to patients who have diabetes to protect their kidneys. ACEs and ARBs are two classes of high blood pressure medications that work on the kidney systems responsible for blood pressure and water balance (7). 

What about patients who do not have diabetes? Study results show that these medications reduced the risk of death significantly in patients with moderate CKD. Most of the patients were considered hypertensive. However, there was a high discontinuation rate among those taking the medications. If you exclude discontinuations, the results are robust with a 63 percent reduction in mortality risk.

What about NSAIDs?

Non-steroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen and naproxen, have been associated with CKD progression and with kidney injury in those without CKD (1). NSAIDs can also interfere with the effectiveness of ACE inhibitors or ARBs. Talk to your doctor about your prescription NSAIDs and any other over-the-counter medications and supplements you are taking.

What should I focus on?

It’s critical to protect your kidneys. Fortunately, basic lifestyle modifications can help; lowering sodium modestly, lowering your protein consumption, and walking frequently may all be viable options. Talk to your physician about your medications and supplements and about whether you need regular screening. 

References:

(1) cdc.gov. (2) niddk.nih.gov (3) Annals of Int Med. 2023;176(6):online. (4) Clin J Am Soc Nephrol. 2014;9(7):1183-9. (5) Cochrane Database Syst Rev. 2020;(10):CD001892. (6) Curr Opin Nephrol Hypertens. 2014;23(6):533-540. (7) J Am Coll Cardiol. 2014;63(7):650-658.

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.

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Our Lady of Hope grotto at Hope Academy in Mount Sinai. Photo courtesy Hope House Ministries

By Fr. Francis Pizzarelli

Fr. Francis Pizzarelli

Recently there have been a series of articles in our major newspapers indicating that our overdose death rate due to heroin and fentanyl are down.

This evidence, although very positive, is also very misleading. As someone who has been in the trenches working with addiction for more than three decades, I do believe that overdose deaths are down. However, I don’t think it’s accurate to conclude that the abuse of heroin and fentanyl is down.

Since the opioid epidemic gained national recognition, most states started to provide Narcan training which is a simple nasal spray that can reverse an overdose.

Since Narcan kits are very accessible and the training is very simple, more and more people are making sure they have a Narcan kit at their parties.

Every morning when I wake up in the little cottage that I live in on the grounds of Hope Academy in Mount Sinai, I see Our Lady of Hope grotto. Nestled in the trees behind the grotto, I see 120 crosses in the garden of remembrance. They represent the 120 mostly young people who have overdosed and died in our larger community since the pandemic.

People come to that garden to find peace and to remember a loved one who has overdosed and died because of the opioid epidemic. It has become holy ground; a safe place for people to gather without shame, blame or guilt.

As most treatment programs will report, no matter what their model, there are no beds available and there are endless waiting lists for people to be treated. In addition, we do not have enough trained professionals in the area of mental health and substance use disorders to treat the epidemic need.

What further alarms me are the proposed Medicaid cuts that will profoundly impact those battling addiction and mental health. If those proposals are put in place, we will clearly see an increase in this senseless loss of life.

Addiction, alcoholism and mental health challenges can be overwhelming for the patient and for the family. But people do recover and reclaim their lives. To empower people on the road to recovery, we need more comprehensive treatment services, not less. We need more profoundly dedicated professionals, not less, if we hope to substantially temper this terrible human tragedy. 

If we stand up to this very important life issue with a loud voice so all can hear us, I am hopeful that we can empower people to stay on the road to recovery and wellness and reclaim their lives.

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

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From left, Tim Matejka, Chief Development Officer, Gurwin Jewish Healthcare Foundation; Maureen Fagan, Assistant Director of Corporate Communications, Gurwin Healthcare System; Stu Almer, President & CEO, Gurwin Healthcare System; Jennifer Carpentieri, VP and Administrator, Gurwin Jewish Nursing &Rehabilitation Center; and Nicole Hopper, Director of Therapeutic Recreation, Gurwin Jewish Nursing & Rehabilitation Center. Photo courtesy of Gurwin

Gurwin Healthcare Systems’ cutting-edge Immersion Room in Commack recently took home top prize in the Innovation Category in the 13th Annual Long Island Imagine Awards.  

Designed for residents with Alzheimer’s disease and other dementias, Gurwin’s Immersion Room was lauded for delivering immersive virtual reality experiences that enhance resident quality of life. 

The annual Imagine Awards competition was created by Cerini & Associates LLP to showcase the good work being done by Long Island’s nonprofit sector. The region’s top organizations are selected to receive the prestigious recognition in the following competitive categories: Arts & Culture, Diversity, Equity, Inclusion & Accessibility (DEIA), Innovation, Leadership Excellence, Rising Star and Social Impact.  

The Innovation Award, sponsored by Flagstar Private Bank, is given to the nonprofit that has been innovative in adopting new platforms that have led to a significant increase in the organization’s ability to meet its mission. 

“We are truly honored to be the recipient of the Flagstar Innovation Award,” said Stuart B. Almer, President and CEO of Gurwin Healthcare System. 

“The Gurwin Immersion Room is bringing patient-centric care to a whole new level for our residents, helping to ease dementia symptoms as well as creating new memorable experiences for visiting families and their loved ones. We are literally putting our residents back in the driver’s seat, helping them reconnect with parts of themselves that in some cases have been lost for years. It is our goal to roll out this transformative technology throughout our other communities within the Gurwin Healthcare System,”  he said.

Located in the heart of the Gurwin Jewish Nursing & Rehabilitation Center’s Memory Care Unit, the Gurwin Immersion Room is the first of its kind in long-term care on Long Island, and was made possible through collaboration with Besser Rooms of Amityville, and grant support from the Alzheimer’s Foundation of America. The Immersion Room incorporates state-of-the-art projector technology, custom-made props and immersive   experiences with stimulating sights, sounds and scents to engage the senses, mitigate symptoms and stir memories from bygone days. Calming scenes are customized to match resident interests, such as a snowy forest, quiet chair yoga, a lively, hands-on virtual drive, or even a roller coaster experience for thrill-seeking residents.

Details about Long Island Imagine Awards and the list of winners in all categories are available at https://www.imagineawardsli.org/finalist/.

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