Over $1 million was raised through the remarkable generosity of attendees at the 3rd Annual Raising Hope Gala, hosted by the New York Cancer Foundation (NYCF), a 501(c)(3) organization dedicated to providing financial assistance to cancer patients in the Greater New York Metro Area. The event, themed “Hope Grows Here,” continued the tradition of supporting the Foundation’s mission to alleviate the financial burdens experienced by patients undergoing cancer treatment.
“It was a remarkable evening surrounded by fellow advocates, friends, and partners, reminding us of the impact we can create when we stand united,” said Jeff Vacirca, MD, CEO of New York Cancer & Blood Specialists and Chairman of the Board, NYCF. “Since its inception, the Foundation has touched the lives of tens of thousands of patients.”
The funds raised will be instrumental in providing financial assistance to cancer patients throughout the Greater New York Metro Area, helping to ease the financial stressors associated with their day-to-day living expenses, including rent/mortgage payments and utility bills.
“It is through the generosity of our attendees—really all of our donors throughout the year—that we are able to help so many patients during their most difficult times. Hope truly grows here!” said Tina Toulon, Executive Director of NYCF.
The Raising Hope Gala also featured several notable guests and moments, including world-renowned photographer Nigel Barker and Art Bodega magazine. A breast cancer survivor and a grant recipient from NYCF shared her inspiring journey, reminding attendees of the profound impact of their support.
A special honoree of the evening was Mr. Ted Okon, Executive Director of the Community Oncology Alliance, whose tireless efforts and advocacy for cancer patients have made a significant difference in the field of oncology.
The NYCF would like to express its deep appreciation for the support of the 2023 sponsors, whose generosity played a pivotal role in the success of the gala:
American Regent
Beigene
Cairo Diagnostics
Daiichi Sankyo
Eagle Pharmaceuticals
Eisai
Gilead
GSK
Novartis
One Oncology
Patient Point
Sanofi
Spectrum Pharmaceuticals
Vanguard Pharma
About the New York Cancer Foundation (NYCF)
The New York Cancer Foundation is a 501 (c)(3) organization that offers financial assistance to patients in the Greater New YorkMetro Area with cancer diagnoses. Our foundation strives to relieve qualified patients of financial stressors of day-to-day livingexpenses, including rent/mortgage payments and utility payments.
Above, 100+ year-old Gurwin nursing home residents welcome Disney to the Gurwin Centenarians Club with official certificate.Photo by Gurwin Jewish Nursing & Rehabilitation Center
More than 300 residents and staff of Gurwin Jewish Nursing & Rehabilitation Center in Commack recently celebrated a century of Disney’s rich history of magic and storytelling with a 100-year jubilee commemorating both the milestone anniversary as well as Gurwin centenarians who inducted Disney into the “Gurwin Centenarian Club. ”
“We are so excited that our residents are able to celebrate Disney’s 100th birthday as if they were actually at Disney themselves,” said Nicole Hopper, CTRS, Director of Therapeutic Recreation at Gurwin Center. “Since our residents are unable to travel to Disney, we decided to bring the magic of Disney to them.”
Gurwin Assisted Living Residents “Visit” Epcot in Celebration of Disney’s 100th Anniversary. Photo from Gurwin Jewish~ Fay J. Lindner Residences
The essence of Magic Kingdom was experienced by all who stepped into the Center’s Simon Rainbow Room’s “100 Years of Wonder” event. Created by Gurwin staff dressed as Mouseketeers and other memorable Disney characters, the spectacular celebration was filled with Disney-themed memorabilia and activities, such as a Magic Kingdom photo booth, meet-and-greet characters and a caricature artist who sketched portraits of the residents and staff.
Gurwin residents enjoyed viewing Disney classics on the big screen, a learn-to-draw Mickey Mouse art station, and decadent Disney theme-park desserts such as churros, soft pretzels and the iconic Disney waffles. The celebration ended in true Disney fashion with the famous “Happily Ever After” firework show displayed on the big screen, much to the delight of residents, family members and staff.
The highlight: a ceremonial induction of Disney into Gurwin’s Centenarian Club.Residents Genevieve Fedele, 103, and soon-to-be 100-year-old Esther Halfon, presented an honorary certificate to Disney as the club’s newest member, offering sage words of advice:“Keep making magic!”
In addition to the celebration at the Gurwin Center, residents of Gurwin’s Assisted Living community, Fountaingate Gardens Independent Living Community and Island Nursing and Rehab Center in Holtsville, also a member of the Gurwin Healthcare System, participated in Epcot-themed celebrations and special Disney magic.
“Our staff across the System poured their hearts into creating enchanting events for all of our residents,” said Stuart B. Almer, President and CEO of Gurwin Healthcare System. “It was a wonderful day of nostalgic festivities, with the icing on the cake being our 100+ year-old residents welcoming Disney into the Gurwin Centenarians Club.We are so fortunate to have such a talented and caring team that creates such amazing experiences for our residents, their families and our staff members as well.”
According to the Centers for Disease Control and Prevention, about 6.7 percent of U.S. adults over the age of 19 have coronary artery disease (CAD), the most common type of heart disease (1). Annually in the U.S., there are 805,000 heart attacks. Of these, 200,000 occur in those who’ve already had a first heart attack.
Among the biggest contributors to heart disease risk are high blood pressure, high cholesterol, and smoking. In addition, if you have diabetes or are overweight or obese, your risk increases significantly. In addition, lifestyle factors contribute to your risk; poor diet, lack of physical activity and high alcohol consumption are among the most significant contributors.
This is where we can dramatically reduce the occurrence of CAD. Evidence continues to highlight lifestyle changes, including diet, as the most important factors in preventing heart disease. Key changes that pack a wallop include the consumption of chocolate, legumes, nuts, fiber and omega-3 polyunsaturated fatty acids (PUFAs).
Chocolate – really?
Preliminary evidence shows that two pieces of chocolate a week may decrease the risk of a heart attack by 37 percent, compared to those who consume less (2). The benefit may be attributed to micronutrients referred to as flavanols.
However, the authors warned against the idea that more is better. High fat and sugar content and chocolate’s caloric density may have detrimental effects when consumed at much higher levels. There is a fine line between potential benefit and harm.
I usually recommend that patients have one to two squares — about one-fifth to two-fifths of an ounce — of high-cocoa-content dark chocolate daily. Aim for chocolate labeled with 80 percent cocoa content.
Alternatively, you can get the benefits without the fat and sugar by adding unsweetened, non-Dutched cocoa powder to a fruit and vegetable smoothie.
Who says prevention has to be painful?
Will increasing dietary fiber help?
We can significantly reduce our risk of heart disease if we increase our consumption of fiber to reach recommended levels. Good sources of fiber are fruits and vegetables eaten with edible skin or peel, beans and lentils, and whole grains.
Fiber has a dose-response relationship to reducing risk. In other words, the more fiber you eat, the greater your risk reduction. In a meta-analysis of 10 studies, results showed that for every 10-gram increase in fiber, there was a corresponding 14 percent reduction in the risk of a cardiovascular event and a 27 percent reduction in the risk of heart disease mortality (3). The authors analyzed data that included over 90,000 men and 200,000 women.
According to a 2021 analysis of National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2018, only 5 percent of men and 9 percent of women get the recommended daily amount of fiber (4). The average American consumes about 16 grams per day of fiber (5).
So, how much is “enough”? The Academy of Nutrition and Dietetics recommends 14 grams of fiber for each 1,000 calories consumed, or roughly 25 grams for women and 38 grams for men (6).
Legumes have an outsized effect
In a prospective (forward-looking) cohort study, the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, legumes reduced the risk of coronary heart disease by a significant 22 percent (7). Those who consumed four or more servings per week saw this effect when compared to those who consumed less than one serving per week. The legumes used in this study included beans, peas and peanuts. There were over 9,500 men and women involved, and the study spanned 19 years of follow-up.
I recommend that patients consume at least one to two servings a day. Imagine the impact that could have, compared to the modest four servings per week used to reach statistical significance in this study.
Focus on healthy nuts
In a study with over 45,000 men, there were significant reductions in CAD with omega-3 polyunsaturated fatty acids (PUFAs). Both plant-based and seafood-based omega-3s showed these effects (8). Good sources of omega-3s from plant-based sources include nuts, such as walnuts, and ground flaxseed. Of course, be cautious about consuming too many nuts, since they’re also calorically dense.
Your ultimate goal should be to become “heart attack proof,” a term used by Dr. Sanjay Gupta and reinforced by Dr. Dean Ornish. While even modest dietary changes can significantly reduce your risk, the more significant the lifestyle changes you make, the closer you will come to achieving this goal.
References:
(1) cdc.gov. (2) BMJ 2011; 343:d4488. (3) Arch Intern Med. 2004 Feb 23;164(4):370-376. (4) nutrition.org (5) NHANES 2009-2010 Data Brief No. 12. Sep 2014. (6) eatright.org. (7) Arch Intern Med. 2001 Nov 26;161(21):2573-2578. (8) Circulation. 2005 Jan 18;111(2):157-164.
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.
If you have diabetes, you are at high risk of vascular complications that can be life-altering. Among these are macrovascular complications, like coronary artery disease and stroke, and microvascular effects, such as diabetic nephropathy and retinopathy.
Here, we will talk about diabetic retinopathy (DR), the number one cause of blindness among U.S. adults, ages 20 to 74 years old (1). Diabetic retinopathy is when the blood vessels that feed the light-sensitive tissue at the back of your eye are damaged, and it can progress to blurred vision and blindness.
As of 2019, only about 60 percent of people with diabetes had a recommended annual screening for DR (2). Why does this matter? Because the earlier you catch it, the more likely you will be able to prevent or limit permanent vision loss.
Over time, DR can lead to diabetic macular edema (DME). Its signature is swelling caused by fluid accumulating in the macula (3). An oval spot in the central portion of the retina, the macula is sensitive to light. When fluid builds up from leaking blood vessels, it can cause significant vision loss.
Those with the longest duration of diabetes have the greatest risk of DME. Unfortunately, many patients are diagnosed with DME after it has already caused vision loss. If not treated early, patients can experience permanent damage (2).
In a cross-sectional study using NHANES data, among patients with DME, only 45 percent were told by a physician that diabetes had affected their eyes (4). Approximately 46 percent of patients reported that they had not been to a diabetic nurse educator, nutritionist or dietician in more than a year — or never.
Unfortunately, the symptoms of vision loss don’t necessarily occur until the latter stages of the disorder, often after it’s too late to reverse the damage.
What are treatment options for Diabetic Macular Edema?
While DME has traditionally been treated with lasers, injections of anti-VEGF medications may be more effective. These eye injections work by inhibiting overproduction of a protein called vascular endothelial growth factor (VEGF), which contributes to DR and DME (5). The results from a randomized controlled trial showed that eye injections with ranibizumab (Lucentis) in conjunction with laser treatments, whether laser treatments were given promptly or delayed for at least 24 weeks, were equally effective in treating DME (6). Other anti-VEGF drugs include aflibercept (Eylea) and bevacizumab (Avastin).
Do diabetes treatments reduce risk of Diabetic Macular Edema?
You would think that using medications to treat type 2 diabetes would prevent DME from occurring as well. However, in the THIN trial, a retrospective study, a class of diabetes drugs, thiazolidinediones, which includes Avandia and Actos, actually increased the occurrence of DME compared to those who did not use these oral medications (7). Those receiving these drugs had a 1.3 percent incidence of DME at year one, whereas those who did not had a 0.2 percent incidence. This incidence was persistent through the 10 years of follow-up. Note that DME is not the only side effect of these drugs. There are important FDA warnings for other significant issues.
To make matters worse, those who received both thiazolidinediones and insulin had an even greater incidence of DME. There were 103,000 diabetes patients reviewed in this trial. It was unclear whether the drugs, because they were second-line treatments, or the severity of the diabetes itself may have caused these findings.
This contradicts a previous ACCORD eye sub-study, a cross-sectional analysis, which did not show an association between thiazolidinediones and DME (8). This study involved review of 3,473 participants who had photographs taken of the fundus (the back of the eye).
What does this ultimately mean? Both studies had weaknesses. It was not clear how long the patients had been using the thiazolidinediones in either study or whether their sugars were controlled and to what degree. The researchers were also unable to control for all other possible confounding factors (9). There are additional studies underway to clarify these results.
Can glucose control and dietimprove outcomes?
The risk of progression of diabetic retinopathy was significantly lower with intensive blood sugar controls using medications, one of the few positive highlights of the ACCORD trial (10). Unfortunately, medication-induced intensive blood sugar control also resulted in increased mortality and no significant change in cardiovascular events. However, an inference can be made: a nutrient-dense, plant-based diet that intensively controls blood sugar is likely to decrease the risk of diabetic retinopathy and further vision complications (11, 12).
If you have diabetes, the best way to avoid diabetic retinopathy and DME is to maintain good control of your sugars. Also, it is imperative that you have a yearly eye exam by an ophthalmologist, so that diabetic retinopathy is detected as early as possible, before permanent vision loss occurs. If you are taking the oral diabetes class thiazolidinediones, this is especially important.
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.
The Suffolk County District Attorney’s Office, 725 Veterans Memorial Highway, Building 77, Hauppauge in conjunction with the DEA and the Suffolk County Sheriff’s Office, will be hosting a “Shed the Meds” event on Saturday, Oct. 28 from 10 a.m. to 2 p.m. Members of the public can bring their unwanted medication or any controlled substance (just no liquids or needles) to either location during the designated time (note, if you have such needles or liquids, they can provide direction as to how to safely dispose of such).
Long-term PPI use increases serious risks. Stock photo
By David Dunaief, M.D,
Dr. David Dunaief
Reflux is common after a large meal. This is when stomach contents flow backward up the esophagus. It occurs because the valve between the stomach and the esophagus, the lower esophageal sphincter, relaxes for no apparent reason. Many incidences of reflux are normal, especially after a meal, and don’t require medical treatment (1).
However, gastroesophageal reflux disease (GERD) is a more serious disorder. It can have long-term health effects, including erosion or scarring of the esophagus, ulcers, and increased cancer risk. Researchers estimate it affects as much as 28 percent of the U.S. adult population (2). No wonder pharmaceutical firms line drug store shelves with over-the-counter and prescription solutions.
GERD risk factors range from lifestyle — obesity, smoking and diet — to medications, like calcium channel blockers and antihistamines. Other medical conditions, like hiatal hernia and pregnancy, also contribute (3). Dietary triggers, such as spicy, salty, or fried foods, peppermint, and chocolate, can also play a role.
One study showed that both smoking and salt consumption increased GERD risk significantly, with increases of 70 percent in people who smoked or who used table salt regularly (4). Let’s examine available treatments and ways to reduce your risk.
What medical options can help with GERD?
The most common and effective medications for treating GERD are H2 receptor blockers (e.g., Zantac and Tagamet), which partially block acid production, and proton pump inhibitors (e.g., Nexium and Prevacid), which almost completely block acid production (5). Both classes of medicines have two levels: over-the-counter and prescription strength. Let’s focus on proton pump inhibitors (PPIs), for which just over 90 million prescriptions are written every year in the U.S. (6).
The most frequently prescribed PPIs include Prilosec (omeprazole) and Protonix (pantoprazole). Studies show they are effective with short-term use in treating Helicobacter pylori-induced peptic ulcers, GERD symptoms, and gastric ulcer prophylaxis associated with NSAID use (aspirin, ibuprofen, etc.) as well as upper gastrointestinal bleeds.
Most of the data in the package inserts is based on short-term studies lasting weeks, not years. The landmark study supporting long-term use approval was only one year. However, maintenance therapy usually continues over many years.
Concerns about long-term usage effects and overprescribing have led to calls among pharmacists to take an active role in educating patients about their risks – along with educating patients about the need to take them before eating for them to work (7).
What are PPI risks?
Side effects after years of use can include increased risk of bone fractures and calcium malabsorption; Clostridium difficile (C. difficile), a serious bacterial infection in the intestines; potential vitamin B12 deficiencies; and weight gain (8).
The FDA has amplified its warnings about the increased risk of C. difficile, which must be treated with antibiotics. Unfortunately, it only responds to a few antibiotics, and that number is dwindling. Patients need to contact their physicians if they develop diarrhea when taking PPIs and the diarrhea doesn’t improve (9).
Suppressing stomach acid over long periods can also result in malabsorption issues. In a study where PPIs were associated with B12 malabsorption, it usually took at least three years’ duration to cause this effect. While B12 was not absorbed properly from food, PPIs did not affect B12 levels from supplementation (10). If you are taking a PPI chronically, have your B12 and methylmalonic acid (a metabolite of B12) levels checked and discuss supplementation with your physician.
Before you stop taking PPIs, consult your physician. Rebound hyperacidity can result from stopping abruptly.
What non-medical options can improve GERD?
A number of modifications can improve GERD, such as raising the head of the bed about six inches, not eating prior to bedtime and obesity treatment, to name a few (11).
Fiber and exercise. The study that quantified the increased risks of smoking and salt also found that fiber and exercise both had the opposite effect, reducing GERD risk (4). An analysis by Journal Watch suggests that the fiber effect may be due to its ability to reduce nitric oxide production, a relaxant for the lower esophageal sphincter (12).
Manage weight. In one study, researchers showed that obesity increases pressure on the lower esophageal sphincter significantly (13). Intragastric (within the stomach) pressures were higher in both overweight and obese patients on inspiration and on expiration, compared to those with a “normal” body mass index.
Avoid late night eating. One of the most powerful modifications we can make to avoid GERD is among the simplest. A study showed a 700 percent increased risk of GERD for those who ate within three hours of bedtime, compared to those who ate four hours or more before bedtime (14).
While drugs have their place in the arsenal of options to treat GERD, lifestyle changes are the first, safest, and most effective approach in many instances.
References:
(1) Gastroenterol Clin North Am. 1996;25(1):75. (2) Gut. 2014; 63(6):871-80. (3) niddk.nih.gov. (4) Gut 2004 Dec; 53:1730-1735. (5) Gastroenterology. 2008;135(4):1392. (6) Kane SP. Proton Pump Inhibitor, ClinCalc DrugStats Database, Version 2022.08. Updated August 24, 2022. Accessed October 11, 2022. (7) US Pharm. 2019:44(12):25-31. (8) World J Gastroenterol. 2009;15(38):4794–4798. (9) FDA.gov. (10) Linus Pauling Institute; lpi.oregonstate.edu. (11) Arch Intern Med. 2006;166:965-971. (12) JWatch Gastro. Feb. 16, 2005. (13) Gastroenterology 2006 Mar; 130:639-649. (14) Am J Gastroenterol. 2005 Dec;100(12):2633-2636.
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.
Members of the Stony Brook Rotary Club at the Oktoberfest 5K. Photo by Aidan Johnson
Scene from the 2023 Stony Brook Rotary’s Oktoberfest 5K. Photo by Aidan Johnson
Scene from the 2023 Stony Brook Rotary’s Oktoberfest 5K. Photo by Aidan Johnson
Scene from the 2023 Stony Brook Rotary’s Oktoberfest 5K. Photo by Aidan Johnson
By Aidan Johnson
Over 150 people participated in the Stony Brook Rotary Club’s Oktoberfest 5K Run Sunday, Oct. 15.
The event, which saw clear skies and mild temperatures, raised money for the Stony Brook Cancer Center’s Mobile Mammography Van, which goes around to different communities to offer free breast cancer screenings.
“This year, we started our new pledge to Stony Brook Cancer Center, who sponsored the mammogram bus,” explained Debbie Van Doorne, president of Stony Brook Rotary.
The fundraiser was timed well since October is Breast Cancer Awareness Month, followed by “Movember,” which raises awareness of breast cancer in men, Van Doorne added.
The Bench Bar & Grill on Route 25A in Stony Brook was the starting and finishing point. As runners returned, they were greeted with refreshments and live music by the band Alternate FRED.
News Flash: Generated by ChatGPT, edited by our staff
• FDA approves RSV vaccines for the first time. These vaccines target the respiratory syncytial virus, a seasonal lung-related illness, with recommendations for adults over 60 and pregnant women in specific gestational weeks.
• Infants under eight months born to mothers without the RSV vaccination can receive monoclonal antibody treatment, providing immunological protection against severe RSV symptoms.
• There are challenges in accessing RSV shots, including delayed processing by insurance companies and pharmacy shortages. Health officials urge residents to advocate for themselves, emphasizing the importance of timely vaccinations given the approaching RSV season.
For the first time, vaccines against the respiratory syncytial virus, or RSV — a lung-related illness that crops up during the fall and winter — have been approved by the U.S. Food and Drug Administration.
The FDA recommends that adults ages 60 and older receive a dose of the vaccine, either Pfizer’s Abrysvo or GSK’s Arexvy, within the next few weeks.
Women in their 32nd to 36th week of pregnancy at some point during September through January are also urged to receive Abrysvo.
For babies born to mothers who didn’t receive a dose of the RSV vaccine, the FDA has approved a monoclonal antibody treatment for infants eight months old and younger that will offer immunological protection against a common and prevalent respiratory condition that can lead to severe symptoms and hospitalizations.
Additionally, the Centers for Disease Control and Prevention recommend a dose of RSV antibody for children between eight and 19 months entering their second RSV season if they have chronic lung disease, are severely immunocompromised, have a severe form of cystic fibrosis or are American Indian or Alaska Natives.
Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. File photo from Stony Brook Medicine
While local doctors welcomed the opportunity to inoculate residents, they said finding these treatments has been difficult.
“People are having a hard time getting” the vaccine, said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital.
Some pharmacies have told patients to come back, which decreases the likelihood that they will return for vaccinations in time, Nachman said.
Additionally, insurance companies have not immediately processed requests for vaccinations, which also slows the process, she said.
Nachman recommended that residents “continue to go back and advocate for yourself” because that is “the only way you’ll get what you need.”
RSV season starts around November, which means residents qualified to receive the vaccine or parents with infants need to reach out to their health care providers now to receive some protection against the virus.
Childhood illness
According to recent data, RSV caused 2,800 hospitalizations per 100,000 children in the first year of life, Nachman said. The range can go as low as 1,500 per 100,000.
However, that only captures the number of hospitalized people and doesn’t include all the times anxious parents bring their sick children to doctor’s offices or walk-in clinics.
“Hospitalizations are the worst of the group, [but] it’s a much bigger pyramid” of people who develop RSV illnesses, Nachman said.
In addition to recommending monoclonal treatment for children under eight months old, the CDC urges parents to get this treatment for vulnerable children who are under two years old.
Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Services. File photo
Like other vaccinations, the RSV vaccine won’t prevent people from getting sick. It will, however, likely reduce the symptoms and duration of the illness.
“In trials, RSV vaccines significantly reduced lower respiratory tract lung infections serious enough to require medical care,” Dr. Gregson Pigott, Suffolk County Health Commissioner, explained in an email.
At its worst, the symptoms of RSV — such as fever, cough and serious respiratory illness — are problematic enough that it’s worth putting out extra effort to receive some immune protection.
“If you’re a little kid or an elderly patient, this is a disease you don’t want to get,” Nachman said.
Pigott said that data analysis shows that RSV vaccines are 85% effective against severe symptoms of the virus.
While people can receive the COVID-19 and flu vaccines simultaneously, doctors recommend getting the RSV vaccine two weeks later.
According to preliminary data, eligible residents may benefit from the RSV vaccine for two seasons, which means they would likely need to receive the shot every other year, according to Pigott.
With two vaccines approved for adults, Pigott recommended that people receive whichever shot is available.
“Both reduce a person’s chances of getting very serious lung infections,” Pigott explained, adding that several measures can help people protect themselves from the flu, RSV and COVID.
Getting a vaccine, washing hands, avoiding touching your eyes, nose or mouth, avoiding close contact with people who are sick with respiratory symptoms and wearing a mask in places where respiratory viruses are circulating can all help.
Those who are symptomatic should stay home when they are sick and wear masks when they are around other people.
Suffolk County Department of Health Services officials indicated they are aware of the challenges of getting shots and monoclonal antibodies and “ask people to be patient.”
'I have seen very good results when treating patients who have eczema with dietary changes.- Dr. David Dunaief
METRO photo
New treatments are evolving
By David Dunaief, M.D.
Dr. David Dunaief
If you have eczema, you’re familiar with its symptoms, which can include rashes, itching, pain and redness. What may not be as clear are its causes and potential implications.
Eczema is a chronic inflammatory process, and it’s likely caused by a combination of genetics and lifestyle choices (1).
While there is no cure, some treatments can ease symptoms and reduce flare-ups. These range from over-the-counter creams and lotions, antihistamines for itchiness, prescription steroid creams, oral steroids, and injectable biologics. Some sufferers use phototherapy for severe cases, but there’s not a lot of research suggesting this is effective. Interestingly, diet may play an important role.
Two separate studies have shown an association between eczema and fracture risk, which we will investigate further.
How does diet affect eczema?
In a Japanese study involving over 700 pregnant women and their offspring, results showed that when the women ate either a diet high in green and yellow vegetables, beta carotene or citrus fruit there was a significant reduction in the risk of the child having eczema of 59 percent, 48 percent and 47 percent, respectively, when comparing highest to lowest consumption quartiles (2).
Elimination diets may also play a role. One study’s results showed when eggs were removed from the diet of those who were allergic, according to IgE testing, eczema improved significantly (3).
From an anecdotal perspective, I have seen very good results when treating patients who have eczema with dietary changes. My patient population includes many patients who suffer from some level of eczema. For example, a young adult had eczema mostly on his extremities. When we first met, these were angry, excoriated, erythematous and scratched lesions. However, after several months of a vegetable-rich diet, the patient’s skin improved significantly.
Do supplements help reduceeczema symptoms?
There are two well-known supplements for helping to reduce inflammation, evening primrose oil and borage oil. Are these supplements a good replacement for – or addition to – medications? The research is really mixed, leaning toward ineffective. There are also some important concerns about them.
In a meta-analysis of seven randomized controlled trials, evening primrose oil was no better than placebo in treating eczema (4).
The researchers also looked at eight studies of borage oil and found there was no difference from placebo in terms of symptom relief. While these supplements only had minor side effects in the study, they can interact with other medications. For example, evening primrose oil in combination with aspirin can cause clotting problems (5).
The upshot? Don’t expect supplements to provide significant help. If you do try them, be sure to consult with your physician first.
Are biologics a good alternative?
Injectable biologics are among the newest treatments and are generally recommended when other treatment options have failed (6). There are two currently approved by the FDA, dupilumab and tralokinumab.
In trials, these injectable drugs showed good results, improving outcomes for moderate to severe eczema sufferers when topical steroids alone were not effective. Like other monoclonal antibodies, they work by interfering with parts of your immune system. They suppress messengers of the white blood cells, called interleukins. This leaves a door open for side effects, like serious infections.
Does eczema affect bone health?
Several studies have examined the relationship between eczema and broken bones. One observational study of 34,500 patients showed that those with eczema had a 44 percent increased risk of injury causing limitation and a 67 percent risk of bone fracture and bone or joint injury for those 30 years and older (7).
If you have both fatigue or insomnia in combination with eczema, you are at higher risk for bone or joint injury than having one or the other alone. The researchers postulated that corticosteroids used in treatment could be one reason, in addition to chronic inflammation, which may also contribute to bone loss risk.
Steroids may weaken bone, ligaments and tendons and may cause osteoporosis by decreasing bone mineral density.
A study of over 500,000 patients tested this theory and found that the association between major osteoporotic fractures and atopic eczema remained, even after adjusting for a range of histories with oral corticosteroids (8). Also, fracture rates were higher in those with severe atopic eczema.
For those who have eczema, it may be wise to have a DEXA (bone) scan.
Eczema exists on a spectrum from annoying to significantly affecting a patient’s quality of life. Supplements may not be the solution, at least not borage oil nor evening primrose oil. However, there may be promising medications for the hard to treat. It might be best to avoid long-term systemic steroids because of their long-term side effects. Diet adjustments appear to be very effective, at least at the anecdotal level.
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.
The Greater Port Jefferson Chamber of Commerce hosted a ribbon cutting ceremony for Harmony & Light Wellness in Port Jefferson on Sept. 30. The event celebrated Harmony’s one-year anniversary and becoming a new chamber partner.
Located at646 Main Street, Lower Level, the business specializes in helping you relax, recharge, reset and rebalance with holistic and sound therapy including the Harmonic Egg.®
Pictured in photo, from left, Nicole Martinsen, Melissa Fesmire, Town of Brookhaven Councilmember Jonathan Kornreich, owner Megan Fesmire (holding scissor), husband Beau and daughter Cassidy.
Operating hours are Tuesday, Thursday and Sunday from 10 a.m. to 3 p.m. and Wednesday, Friday and Monday from 10 a.m. to 8 p.m. For more information, call 631-828-5055.
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