Mather Hospital, 75 North Country Road, Port Jefferson has created a new Cardiac Rehabilitation Program designed to help those who have suffered a major cardiac event such as a heart attack regain their overall physical, mental, and social functioning.
Studies show that individuals who have recent cardiac events and who participate in cardiac rehabilitation realize many benefits including increased life expectancy; reduced hospitalization; improved function, exercise capacity, mood and overall quality of life; a strong correlation between number of cardiac rehabilitation sessions and long-term results; and improvement of modifiable risk factors such as physical activity, dietary choices, stress levels and more.
The program, which is housed in the Frey Family Foundation Medical Arts Building on the Mather campus, is tailored to meet individual needs, combining education and exercise in a supportive environment.
After an initial evaluation Mather Hospital’s Cardiac Rehabilitation service guides patients through a 12-week program that includes exercise training with continuous ECG or heart monitoring, educational classes on heart health, and nutrition counseling.
Their team includes experienced cardiologists, registered nurses, physical therapists, registered dietitians, and licensed social workers. Together, they providea thorough health assessment and set up a personalized treatment plan to maximize a patient’s recovery and return to well-being. Learn more at matherhospital.org/cardiacrehab, or call 631-775-2426.
Veterinarian Steven Templeton, of Animal Health & Wellness in Setauket, pets his two rescue dogs Penny and Emmy. Penny, the black dog, recently passed away. Photo by Stephanie Templeton
Long Island veterinarians are scratching their heads, unsure of whether reports of a new and as yet poorly-defined respiratory illness in dogs is a new threat or whether the ongoing talk is something of a shaggy dog tale.
“No one knows what it is,” said Steven Templeton, a veterinarian at Animal Health & Wellness in Setauket. “Nobody seems to have a clue. Some suggested it was a weird new bacteria, while others suggested it was viral.”
As of now, a potential respiratory infection, which hasn’t been well-defined and differs in its origin depending on whom you ask, could be contributing to making some dogs in other parts of the country sicker than they might otherwise be from the usual assortment of canine maladies that strike at this time of year.
Templeton has seen an increase in respiratory cases in his practice, although none of the cases has become severe.
Some of the illnesses he’s treated are coming from dogs that have no known exposure to other dogs, which “makes you wonder if they’re not catching it from dogs, and if they’re catching it from people,” Templeton added. “It could be a variant of the flu or COVID.”
When Templeton graduated from veterinary school in 1989, he said the conventional wisdom was that dogs didn’t give people viruses and vice versa. Now, he said, that’s turned around, and humans and their best friends can and do share illnesses.
With conflicting reports that this illness could be viral or bacterial, the infection could be a grab bag description for more than one health threat, Templeton said.
As of now, this mysterious dog illness has reportedly affected dogs in 14 states.
At Animal Emergency Services in Middle Country Road in Selden, veterinarian Melody Ribeiro has had one pneumonia case in a dog, which was straightforward in its treatment.
The dog recovered.
Advice for dog owners
Dog owners have been asking about reports of this infection.
Ribeiro suggested people who are planning to travel check out the facility where they are bringing their pet to make sure they know how the dogs are handled.
Vets also recommended asking kennels or other boarding facilities if they isolate dogs who are coughing or might be contagious.
Templeton, who finds someone who can care for his dogs at home when he travels, added that minimizing group dog contact at this point might also help.
Similar to the advice health care providers who work with people offered during COVID, veterinarians suggested that dog owners should take special precautions with beloved pets who might be in vulnerable categories or who have underlying medical conditions.
Dogs who are particularly young or old, have conditions that weaken their immune system, have poor organ function or are not fully immunocompetent should stay away from gatherings where they might contract viral or bacterial infections.
“We say the same thing for animals that we say for humans for COVID,” said Templeton. “If they have underlying issues, stay away from public [gatherings]. They could be asking for trouble.”
Other dog challenges
Apart from the threat of one or a combination of infections, veterinarians also suggested that dogs continue to struggle with the carry-over from a pandemic that kept many of their human friends home for extended periods of time.
Dogs “feed off the emotions of their owners,” said Templeton. Owners who are stressed or who are angrier than normal can bring tension into their homes that can make their dogs act out.
Dog owners are increasingly asking veterinarians for drugs to help their dogs cope with anxiety or emotional problems.
“The drug approach is minimally effective,” Templeton said. He urged people to get their dogs training and to work with their pets to minimize their distress.
“Anxious owners have anxious dogs,” added Ribeiro.
Holiday risks
During the holidays, dogs can also get into foods they shouldn’t eat, which can lead to pancreatitis, Ribeiro said.
With the legalization of pot, dogs are also consuming products that have tetrahydrocannabinol, or THC.
The accidental consumption of THC has occurred over the last few years, with dogs coming in who need medical attention, Ribeiro said. Veterinarians urged people to be cautious about where they store their gummies or other products that might prove an irresistible attraction to their dogs.
Emma Clark Library, 120 Main St., Setauket hosts a Shed the Meds event on Wednesday, Dec. 6 from noon to 4 p.m. Members of the Suffolk County Sheriff’s Office will be on hand in the historic section of the library to properly dispose of unused medications. Proper disposal is essential to protect the environment and ensure that old drugs don’t end up in the wrong hands. There is no registration required and all are welcome.
Please note: The Suffolk County Sheriff’s Office cannot accept any liquids, needles, creams, or ointments of any kind. They are only accepting unused or expired medications from individuals (not large quantities from a doctor’s office or health care facility).
Now that we’re settling into the cooler winter months, dehydration is resurfacing as a challenge. Dry heat makes it hard to stay hydrated or to keep any humidity in your home or office, which can dehydrate your body.
Complications and symptoms of dehydration can be mild to severe, ranging from constipation, mood changes, itchy skin, headaches and heart palpitations to heat stroke, migraines and heart attacks.
The dry air can also make our throats and sinuses dry, making us uncomfortable and more susceptible to irritations and viruses.
Let’s look at some suggestions for keeping hydration up and some consequences of dehydration.
How do you keep humidity in the air?
To reduce sinus inflammation and dry skin that heated air can promote, measure the humidity level in your home with a hygrometer and target keeping it between 30 and 50 percent (1). When the temperature outside drops below 10 degrees Fahrenheit, lower this to 25 percent.
Strategies for adding moisture to the air include using cool mist humidifiers, keeping the bathroom door open after you bathe or shower, and placing bowls of water strategically around your home, including on your stovetop when you cook. If you use a humidifier, take care to follow the manufacturer’s care instructions and clean it regularly, so you don’t introduce bacteria to the air.
Reducing headaches and migraines
In a review of studies published in the Handbook of Clinical Neurology, those who drank four cups or more of water had significantly fewer hours of migraine pain than those who drank less (2). Headache intensity decreased as well.
Decreasing heart palpitations
Heart palpitations are very common and are broadly felt as a racing heart rate, skipped beat, pounding sensation or fluttering. Dehydration and exercise contributing to this (3). They occur mainly when we don’t hydrate before exercising. If you drink one glass of water before exercise and then drink during exercise, it will help avoid palpitations. Though these symptoms are not usually life-threatening, they can make you anxious.
Lowering heart attack risk
The Adventist Health Study showed that men who drank more water had the least risk of death from heart disease (4). Group one, which drank more than five glasses of water daily, had less risk than group two, which drank more than three. Those in group three, which drank fewer than two glasses per day, saw the lowest benefit, comparatively. For women, there was no difference between groups one and two, although both fared better than group three.
The reason for this effect, according to the authors, may relate to blood or plasma viscosity (thickness) and fibrinogen, a substance that helps clots form.
Decreased concentration and fatigue
Mild dehydration resulted in decreased concentration, subdued mood, fatigue and headaches in women in a small study (5). The mean age of participants was 23, and they were neither athletes nor highly sedentary. Dehydration was caused by walking on a treadmill with or without taking a diuretic (water pill) prior to the exercise. The authors concluded that adequate hydration was needed, especially during and after exercise.
I would also suggest, from my practice experience, hydration prior to exercise.
How much water should you drink?
How much water we need to drink depends on circumstances, such as diet, activity levels, environment and other factors. It is not true necessarily that we all should be drinking eight glasses of water a day. In a review article, researcher analyzed the data, but did not find adequate studies to suggest that eight glasses is the magic number (6). It may actually be too much for some patients.
You may also get a significant amount of water from the foods in your diet. Nutrient-dense diets, like Mediterranean or Dietary Approaches to Stop Hypertension (DASH) diets, have a plant-rich focus. Diets with a focus on fruits and vegetables increase water consumption (7). As you may know, 95 percent of the weights of many fruits and vegetables are attributed to water. An added benefit is an increased satiety level without eating calorically dense foods.
Remember that salty foods can dehydrate you, including breads and pastries, so try to avoid these.
Should you avoid caffeinated beverages?
In a review, it was suggested that caffeinated coffee and tea don’t increase the risk of dehydration, even though caffeine is a mild diuretic (8). With moderate amounts of caffeinated beverages, the liquid in them has a more hydrating effect than its diuretic effect. It is important to stay hydrated to avoid uncomfortable — and sometimes serious — complications. Diet is a great way to ensure that you get the triple effect of high nutrients, increased hydration and sense of feeling satiated without calorie-dense foods. However, don’t go overboard with water consumption, especially if you have congestive heart failure or open-angle glaucoma (9).
References:
(1) epa.gov (2) Handb Clin Neurol. 2010;97:161-72. (3) my.clevelandclinic.org. (4) Am J Epidemiol 2002 May 1; 155:827-33. (5) J. Nutr. February 2012 142: 382-388. (6) AJP – Regu Physiol. 2002;283:R993-R1004. (7) Am J Lifestyle Med. 2011;5(4):316-319. (8) Exerc Sport Sci Rev. 2007;35(3):135-140. (9) Br J Ophthalmol. 2005:89:1298–1301.
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.
From left, Mary Joy Pipe, PJCC Director; Caitlin Thomson, Kiddsmiles Office Manager; Lance (husband to Dr. Alstodt); Dr. Michele Alstodt, owner of Kiddsmiles Port Jeff Station; Stu Vincent, PJCC President; and Amanda Saviano Kiddsmiles Regional Manager. Photo from PJCC
The Greater Port Jefferson Chamber of Commerce welcomed new partner Kiddsmiles Pediatric Dentistry with a ribbon cutting ceremony on Nov. 16.
Located at 1174 Route 112, Suite B, in Port Jefferson Station, the office is the 3rd location in Suffolk County along with Holbrook and North Babylon and is equipped with the latest state of the art technology including laser dentistry (no needle fillings), digital x-rays and computer imaging in a kid-friendely environment.
Pictured in photo from left, Mary Joy Pipe, PJCC Director; Caitlin Thomson, Kiddsmiles Office Manager; Lance (husband to Dr. Alstodt); Dr. Michele Alstodt, owner of Kiddsmiles Port Jeff Station; Stu Vincent, PJCC President; and Amanda Saviano, Kiddsmiles Regional Manager.
“Thank you to the Port Jefferson Chamber of Commerce and the incredible community for their warm welcome and support.Our team is beyond excited to bring our specialized pediatric dental care to Port Jefferson Station. Come visit us at our new location and experience the Kiddsmiles difference firsthand! We can’t wait to meet you and your little ones,” read a post from Kiddsmiles’ Facebook after the ribbon cutting.
Office hours are Monday, Wednesday and Thursday from 10 a.m. to 6 p.m., Saturday from 8 a.m. to 1 p.m., closed Tuesday, Friday and Sunday. For more information, call 631-254-5437 or visit www.kiddsmiles.com/port-jefferson-station.
Focus on healthier holiday dinner options.
METRO photo
By David Dunaief, M.D.
Dr. David Dunaief
How hard is it to maintain healthy eating habits during the holidays? Even when we have the best of intentions, it’s hard to resist indulging in seasonal favorites and secret family recipes spread before us in a sprawling buffet.
Unfortunately, that one meal, and perhaps subsequent leftover meals, can have striking health consequences. And if you tend to overeat, be aware that there are significant short-term consequences of stuffing ourselves.
Not surprisingly, Americans tend to gain weight between Thanksgiving and New Year’s Day. This is when many accumulate the greatest weight gain of the year, and most do not lose the weight they gain during this time (1). If you can avoid weight gain during the holidays, think of the possibilities for the rest of the year.
Those who are obese and sedentary may already have heart disease. Overeating during a single meal increases your risk of heart attack over the near term, according to the American Heart Association (2).
The good news is that, with a little planning, you can reap significant health benefits.
What can we do to turn a holiday dinner into a healthier meal? The secret is likely there on your table, hidden in the side dishes. By reconsidering how we prepare them, we can change the Thanksgiving health equation.
Focus on plants
Phytochemicals (plant nutrients) called carotenoids have antioxidant and anti-inflammatory effects and are found mostly in fruits and vegetables. Carotenoids make up a family of more than 600 different substances, such as beta-carotene, alpha-carotene, lutein, zeaxanthin, lycopene and beta-cryptoxanthin (3).
Carotenoids help to prevent and potentially reverse diseases, such as breast cancer, amyotrophic lateral sclerosis (Lou Gehrig’s disease), age-related macular degeneration, and cardiovascular disease — heart disease and stroke. Foods that contain these substances are dark green leafy vegetables, as well as orange, yellow and red vegetables and fruits.
Focus on presentation and perception
Despite the knowledge that healthy eating has long-term positive effects, there are obstacles to healthy eating. Two critical factors are presentation and perception.
Vegetables are often prepared in either an unappetizing way — steamed to the point of no return – or smothered in cheese and butter, negating any benefits. Fruits are buttered and sugared beyond recognition or used as a garnish for more decadent dishes.
Other plant-based foods, like whole grains and leafy greens, are relegated to side dishes or afterthoughts.
Here are some suggestions to get you thinking about ways to shift the heavy holiday meal paradigm.
• Make healthy, plant-based dishes more appetizing. You don’t have to forgo signature dishes, but supplement tradition by adding mouthwatering vegetable-based dishes. One of my favorites is steamed “sweet” vegetables – cauliflower, broccoli, snap peas, onions and garlic. To make it sweet, I sauté it in a splash of citrus-infused balsamic vinegar and add sliced apples. Who doesn’t love poached apples? If you want to make this a primary dish, add diced tofu and/or garbanzo beans to make it more filling without overwhelming its delicate sweetness.
• Season your vegetables. Why would you serve vegetables without any seasoning? In my family, we season vegetables and make sauces to drizzle over them. Personally, I’m a fan of infused vinegars. Each adds a different flavor to the vegetables.
My 17-year-old nephew, who has never liked cooked vegetables, fell in love with my wife’s roasted Brussels sprouts and broccoli while on summer vacation together. He texted her afterward to ask for the recipes, which are surprisingly simple. Now, he makes them for himself. Good resources for appealing vegetable dishes can be found at PCRM.org, mouthwateringvegan.com, and many other online resources.
• Replace refined grains. A study in the American Journal of Clinical Nutrition showed that replacing wheat or refined grains with whole wheat and whole grains significantly reduced central fat, or belly fat (4). Not only did participants lose subcutaneous fat found just below the skin, but also visceral adipose tissue, the fat that lines organs and causes chronic diseases such as cancer.
For even better results, consider substituting riced cauliflower or mashed cauliflower for rice or potatoes. You can purchase frozen riced cauliflower in many grocery stores now. Just be sure to get one that’s unsalted. If you prefer mashed, here’s a simple recipe for mashed cauliflower: https://medicalcompassmd.com/post/mashed-cauliflower-recipe-vegan.
• Offer healthy snacks. Instead of laying out creamy dips, cheese platters and candies as snacks, choose whole grain brown rice crackers, baby carrots, cherry tomatoes and healthy dips like low-salt hummus and salsa. Help people choose wisely.
• Improve dessert options. Options might include dairy-free, sugar-free pumpkin pudding and fruit salad.
The goal should be to increase your nutrient-dense choices and decrease your empty-calorie foods.
Instead of making Thanksgiving a holiday of regret, eating foods that cause weight gain, fatigue and that increase your risk for chronic diseases, promote good health while serving a delicious, festive meal.
References:
(1) N Engl J Med 2000; 342:861-867. (2) www.heart.org. (3) Crit Rev Food Sci Nutr 2010;50(8):728–760. (4) Am J Clin Nutr 2010 Nov;92(5):1165-71.
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.
Adam Gonzalez, PhD, Associate Professor and Vice Chair of Behavioral Health in the Department of Psychiatry and Behavioral Health in the Renaissance School of Medicine (RSOM) at Stony Brook University, is one of 11 fellows in New York State to be named to the State University of New York’s (SUNY) Hispanic Leadership Institute (HLI) Class for 2024.
A licensed clinical psychologist and researcher, Dr. Gonzalez is an expert in cognitive behavioral treatment for mood and anxiety disorders, relaxation and mindfulness-based treatments, and behavioral medicine. His research, including work focused on evaluating stress management and resilience training programs, has been supported by over $5 million in federal funding.
“I am incredibly honored to have been selected as a fellow for the SUNY HLI 2024 cohort,” said Dr. Gonzalez, who will begin his 2024 HLI experience in January. “Thank you to SUNY leadership for this opportunity. I look forward to learning from others and doing my part to advance SUNY’s mission.”
The Mastic Beach resident is the Founding Director of Stony Brook’s Mind-Body Clinical Research Center, which seeks to improve the mental and physical health of individuals and communities through providing integrative mental and physical healthcare, conducting basic and applied innovative research, and training tomorrow’s clinical research leaders. And much of his work with colleagues accelerated during the height of the Covid-19 pandemic, with programs and services dedicated to both patients and healthcare workers.
“By working to increase Hispanic and ally representation in leadership positions, the HLI provides its fellows with the skills needed to ensure they are represented at the decision-making table and know they’ll be valued and supported throughout their careers at SUNY,” Chancellor King said in a statement, adding that Dr. Gonzalez and the other class members “are role models to colleagues and students, and we congratulate them as they start their HLI journey. I would also like to thank our legislative partners for their continued and unwavering commitment to the success of the HLI.”
Since its inception in 2017, HLI has named fellows to the program to take part in a demanding six-month experience for SUNY leaders of Hispanic descent and their allies that position them to develop further higher education leadership skills and proficiencies. HLI fellows participate in training sessions and webinars, and converse with national and statewide Hispanic leaders. HLI creates a pipeline for professional opportunities across SUNY and ensures alumni are networking and receiving continuous support and mentorship. HLI is housed within SUNY’s Office Diversity, Equity, and Inclusion.
As the weather has started to turn cooler, I’ve been hearing a lot more sniffling and sneezing. It’s a good reminder that cold season is upon us. Most frequently caused by the human rhinovirus, a cold’s effects can range from an annoyance to more serious symptoms that put us out of commission for a week or more.
The good news is that it may be possible to reduce the symptoms — or even reduce the duration — of a common cold with lifestyle management and a few dietary supplements.
What can you do to relieve cold symptoms?
If you have congestion or coughing symptoms, sitting in a steamy bathroom may help. It simulates a medical mist tent, moisturizing your nasal and bronchial passages. Dry heat is your enemy when you’re experiencing cold symptoms. If your home or office is dry, use a cool mist humidifier to put some humidity back in the air.
Eating salt-free soups loaded with vegetables can help increase your nutrient intake and loosen congestion. I start with a sodium-free soup base and add in spices, onions, spinach, broccoli, and other greens until it’s more stew-like than soup-like. Caffeine-free hot teas will also help loosen congestion and keep you hydrated.
Does Zinc reduce a cold’s duration?
You may have heard that zinc helps treat a cold. I have good news: it does!
According to a meta-analysis that included 13 trials, zinc in any form taken within 24 hours of your first symptoms may reduce the duration of a cold by at least one day (1). Even more importantly, zinc may significantly reduce the severity of your symptoms throughout, improving your quality of life. This may be due to an anti-inflammatory effect.
One of the studies, published in the Journal of Infectious Disease, found that zinc reduced the duration of the common cold by almost 50 percent from seven days to four days, cough symptoms were reduced by greater than 60 percent, and nasal discharge was reduced by 33 percent (2). Researchers used 13 grams of zinc acetate per lozenge taken three-to-four times daily for four days. This translates into 50-65 mg per day.
Be aware, however, that there are a few serious concerns with zinc. First, the dose researchers used was well above the maximum intake recommended by the National Institutes of Health, which is 40 mg per day for adults. This maximum intake number is less for those 18 and younger (3). Also, the FDA has warned against nasal zinc administration with sprays, which has led to permanent loss of smell for some people.
Not all studies showed a benefit. Also, studies where there was a proven benefit may have used different formulations, delivery systems and dosages, and there is no current recommendation or consensus on what is optimal.
Does vitamin C help cure a cold?
According to a review of 29 trials with a combined population of over 11,000, vitamin C did not show any significant benefit in preventing or reducing cold symptoms or duration in the general population (4). With this in mind, there may be no reason to take mega-doses of vitamin C for cold prevention and treatment. However, in a sub-group of serious marathon runners and other athletes, there was substantial risk reduction when taking vitamin C prophylactically; they caught 50 percent fewer colds.
Is echinacea a possible cure?
After review of 24 controlled clinical trials, the Cochrane Database notes that the jury is still out on the effectiveness of echinacea for treatment of duration and symptoms, but the results are disappointing and inconsistent (5). There are no valid randomized clinical trials showing cold prevention using echinacea.
In a randomized controlled trial with 719 patients, echinacea was no better than placebo for the treatment of the common cold (6).
Should you exercise or not?
People with colds need rest — at least that was the theory. However, a study published in the British Journal of Sports Medicine may change this perception. Participants who did aerobic exercise at least five days per week, versus one or fewer days per week, had a 43 percent reduction in the number of days with colds over two 12-week periods during the fall and winter months (7). Even more interesting is that those who reported themselves as being highly fit had a 46 percent reduction in the number of days with colds compared to those who perceived themselves to have low fitness. Their cold symptoms were reduced significantly as well.
What are our takeaways?
For symptom relief, simple home remedies may actually work better than supplements. Zinc might be useful in treating and preventing the common cold. Use caution with dosing, however, to reduce its side effects. Echinacea and vitamin C have not been proven to provide benefits, but don’t stop taking them if you feel they help you. Lastly, exercise might actually reduce your cold’s duration.
References:
(1) Open Respir Med J. 2011; 5: 51–58. (2) J Infect Dis. 2008 Mar 15;197(6):795-802. (3) ods.od.nih.gov. (4) Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD000980. (5) Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No.: CD000530. (6) Ann Intern Med. 2010;153(12):769-777. (7) British Journal of Sports Medicine 2011;45:987-992.
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.
Increasing tomato sauce consumption is a simple way to decrease your prostate cancer risk
By David Dunaief, M.D.
Dr. David Dunaief
Welcome to “Movember,” a month dedicated to raising money to fund awareness and research initiatives focused on men’s health (1). An initiative of the Movember Foundation, its efforts have funded 1,320 men’s health projects globally, with focuses on mental health, suicide prevention, testicular and prostate cancer.
Its prostate cancer initiatives focus on early detection, treatment options, and quality of life considerations for different treatments. I’d like to add prevention options to the conversation. Regardless of your family history, you can reduce your risk of prostate cancer with some simple lifestyle changes.
How does obesity affect prostate cancer risk?
Obesity may slightly decrease the risk of nonaggressive prostate cancer; however, it may also increase your risk of aggressive disease (2). Because larger prostates make biopsies less effective, the study’s authors attribute a lower incidence of nonaggressive cancer to the possibility that it is more difficult to detect it in obese men. Ultimately, those who are obese have a greater risk of dying from prostate cancer when it is diagnosed.
Does consuming animal fat affect your risk?
There appears to be a direct effect between the amount of animal fat we consume and the incidence of prostate cancer. In the Health Professionals Follow-up Study, those who consumed the highest amount of animal fat had a 63 percent increased risk of advanced or metastatic prostate cancer, compared to those who consumed the least (3).
Also, in this study, red meat contributed to an even greater, approximately 2.5-fold, increased risk of advanced disease. If you continue to eat red meat, reduce your frequency as much as possible, targeting once a month or quarter.
In another large, prospective observational study, the authors concluded that red and processed meats increase the risk of advanced prostate cancer through heme iron, barbecuing/grilling and nitrate/nitrite content (4).
Should you cook your tomatoes?
Tomato sauce has been shown to potentially reduce the risk of prostate cancer. However, uncooked tomatoes have not demonstrated the same beneficial effects. It is believed that lycopene, which is a type of carotenoid found in tomatoes, is central to this benefit. Tomatoes need to be cooked to release lycopene (5).
As part of this larger study, 32 patients with localized prostate cancer consumed 30 mg of lycopene per day via tomato sauce-based dishes over a three-week period before a radical prostatectomy. Key cancer indicators improved, and tissue tested before and after the intervention showed dramatic improvements in DNA damage in leukocyte and prostate tissue (6).
In a prospective study involving 47,365 men who were followed for 12 years, prostate cancer risk was reduced by 16 percent with higher lycopene intake from a variety of sources (7). When the authors looked at tomato sauce alone, they saw a 23 percent risk reduction when comparing those who consumed at least two servings a week to those who consumed less than one serving a month. The reduction in severe, or metastatic, prostate cancer risk was even greater, at 35 percent. This was a statistically significant reduction in risk with a very modest amount of tomato sauce.
Unfortunately, many brands of prepared tomato sauce are loaded with salt, which has its own health risks. I recommend to patients that they either make their own sauce or purchase prepared sauce made with low sodium or no salt.
Do cruciferous vegetables help?
While results among studies vary, they all agree: consuming vegetables, especially cruciferous vegetables, helps reduce prostate cancer risk.
In a case-control study, participants who consumed at least three servings of cruciferous vegetables per week, versus those who consumed less than one per week, saw a 41 percent reduction in prostate cancer risk (8). What’s even more impressive is the effect was twice that of tomato sauce, while the intake was similarly modest. Cruciferous vegetables include broccoli, cauliflower, bok choy, kale and arugula, to name a few.
A separate study of 1,338 patients with prostate cancer in a larger cancer screening trial concluded that, while vegetable and fruit consumption did not appear to lower outright prostate cancer risk, increased consumption of cruciferous vegetables — specifically broccoli and cauliflower — did reduce the risk of aggressive prostate cancer, particularly of more serious stage 3 and 4 tumors (9). These results were seen with consumption of just one or more servings of each per week, when compared to less than one per month.
What about PSA screening?
In a retrospective analysis of 128 U.S. Veteran’s Health Administration facilities, those where Prostate-specific antigen (PSA) screening was less frequent found higher rates of metastatic prostate cancer (10). During the study period from 2005 to 2019, researchers found an inverse relationship between PSA screening rates and metastatic prostate cancer. When screening rates decreased, rates of metastatic cancer increased five years later, while in facilities where screening rates increased, metastatic cancer rates decreased.
While the study authors caution about extending these findings to the general population, they do suggest they could help inform conversations between men and their physicians about the value of PSA screening.
When it comes to preventing prostate cancer and improving prostate cancer outcomes, lifestyle modifications, including making dietary changes, can reduce your risk significantly.
References:
(1) www.movember.com. (2) Epidemiol Rev. 2007;29:88. (3) J Natl Cancer Inst. 1993;85(19):1571. (4) Am J Epidemiol. 2009;170(9):1165. (5) Exp Biol Med (Maywood). 2002; 227:914-919. (6) J Natl Cancer Inst. 2002;94(5):391. (7) Exp Biol Med (Maywood). 2002 Nov;227(10):886-93. (8) J Natl Cancer Inst. 2000;92(1):61. (9) J Natl Cancer Inst. 2007;99(15):1200-1209. (10) JAMA Oncol. 2022 Dec 1;8(12):1747-1755.
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.
Community Medicaid is the program that covers care at home, such as a personal care aide. Chronic Medicaid is the program that covers nursing home care.
The requirements and application process for Community and Chronic Medicaid are very different. An applicant’s marital status implicates a different set of rules. It is important to know the differences and make sure you have the correct Medicaid in effect.
For 2023, an individual applying for Community Medicaid can have no more than $30,182 in assets, excluding the home if the equity is less than $1,033,000. Qualified funds such as IRAs or 401(K)s are exempt, so long as the applicant is taking minimum distributions, and which are counted towards the monthly income allowance. The applicant’s income cannot exceed $1,677 per month — but there are ways to capture the income using a Pooled Income Trust.
While these limitations may seem daunting, the good news about Community Medicaid is that there currently is no look-back period. No look-back means someone looking to get care at home can transfer assets out of their name and be eligible the following month.
It is important to keep in mind, however, that in April of 2020 New York State passed a law introducing a 30-month look-back period for Community Medicaid. The look-back period was originally set to take effect in October 2020, but was delayed. The New York State Department of Health recently announced that the earliest the 30-month look-back period will be implemented, if ever, is mid to late 2025.
To qualify for Chronic Medicaid in 2023 an individual applicant can have no more than $30,182 in assets, and no more than $50.00 per month in income. There is no pooled trust option to protect excess income, so any income exceeding $50 per month will go towards the cost of the nursing home care. Like Community Medicaid, qualified funds such as IRAs or 401(K)s are exempt if the applicant is required to take minimum distributions. The home is not an exempt resource unless a spouse, disabled or minor child is living there.
Chronic Medicaid has a five-year look-back period. This refers to the period of time that the Department of Social Services will review your financials to determine if you made any transfers. To the extent that the applicant has made transfers or has too many assets in their name to qualify, they will be ineligible for Medicaid. However, there are exempt transfers that the applicant can make which will not render them ineligible:
— A spouse;
— A child under the age of 21;
— A blind or disabled child;
— A sibling who has an “equity interest” in the home and who has lived in the home for at least a year before the Medicaid application is filed; or
— A “caretaker” child who has lived in the parent’s home for at least two years before the Medicaid application is filed.
Due to the complexities of eligibility for Community and Chronic Medicaid, it is imperative to consult with an expert attorney in the field.
Nancy Burner, Esq. is a Partner at Burner Prudenti Law, P.C. focusing her practice areas on Estate Planning and Trusts and Estates. Burner Prudenti Law, P.C. serves clients from New York City to the east end of Long Island with offices located in East Setauket, Westhampton Beach, Manhattan and East Hampton.
One of the studies, published in the Journal of Infectious Disease, found that zinc reduced the duration of the common cold by almost 50 percent from seven days to four days, cough symptoms were reduced by greater than 60 percent, and nasal discharge was reduced by 33 percent (2). Researchers used 13 grams of zinc acetate per lozenge taken three-to-four times daily for four days. This translates into 50-65 mg per day.
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