CLOSE
Health

by -
0 102
Stock photo

By David Dunaief, M.D.

Dr. David Dunaief

Heart failure (HF) occurs when the heart’s pumping is not able to keep up with the body’s demands for blood and oxygen and may decompensate. Unlike a heart attack, which is acute, heart failure is a slowly developing disease that may take years to become symptomatic.

As of 2018, there were about 6.2 million Americans living with heart failure, and heart failure was a potential contributing factor in 13.4 percent of deaths (1).

There are two types of heart failure, systolic and diastolic. The basic difference is that the ejection fraction, the output of blood with each contraction of the left ventricle of the heart, is more or less preserved in diastolic HF, while it can be significantly reduced in systolic HF.

We have more evidence-based medicine, or medical research, on systolic heart failure. Fortunately, both types can be diagnosed with the help of an echocardiogram, an ultrasound of the heart. The signs and symptoms may be similar, as well, and include shortness of breath on exertion or when lying down, edema or swelling, reduced exercise tolerance, weakness and fatigue.

Major lifestyle risk factors for heart failure include obesity; smoking; poor diet, including consuming too much sodium; being sedentary; and drinking alcohol excessively. Pre-existing conditions that are significant risk factors include diabetes, coronary artery disease and high blood pressure.

Typically, heart failure is treated with blood pressure medications, such as beta blockers, ACE inhibitors and angiotensin receptor blockers. We are going to look at how diet, iron and the supplement CoQ10 impact heart failure.

Antioxidant diet’s impact

If we look beyond the usual risk factors mentioned above, oxidative stress may play an important role as a contributor to HF. Oxidative stress is thought to result in damage to the inner lining of the blood vessels, or endothelium, oxidation of cholesterol molecules and a decrease in nitric oxide, which helps vasodilate blood vessels.

In a population-based, prospective (forward-looking) study, called the Swedish Mammography Cohort, results show that a diet rich in antioxidants reduces the risk of developing HF (2). In the group that consumed the most nutrient-dense foods, there was a significant 42 percent reduction in the development of HF, compared to the group that consumed the least. According to the authors, the antioxidants were derived mainly from fruits, vegetables, whole grains, coffee and chocolate. Fruits and vegetables were responsible for the majority of the effect.

This nutrient-dense approach to diet increased oxygen radical absorption capacity. Oxygen radicals have been implicated in cellular and DNA damage, potentially as a result of increasing chronic inflammation. What makes this study so impressive is that it is the first of its kind to investigate antioxidants from the diet and their impacts on heart failure prevention.

This was a large study, involving 33,713 women, with good duration — follow-up was 11.3 years. There are limitations to this study, because it is observational and the population involved only women. Still, the results are very exciting, and it is unlikely there is a downside to applying this approach to the population at large.

CoQ10 benefits

Coenzyme Q10 is a substance produced by the body that helps the mitochondria (the powerhouse of the cell) produce energy. It is thought of as an antioxidant. 

Results of the Q-SYMBIO study, a randomized double-blind control trial, showed an almost 50 percent reduction in the risk of all-cause mortality and 50 percent fewer cardiac events with CoQ10 supplementation (3). This one randomized controlled trial followed 420 patients for two years who had severe heart failure. This involved using 100 mg of CoQ10 three times a day compared to placebo.

The lead author goes as far as to suggest that CoQ10 should be part of the paradigm of treatment. CoQ10 is the first supplement to show survival benefits in heart failure.

This study’s rigor is impressive; it assesses the supplement as if it were a drug. A subsequent 2019 sub-group analysis of Q-SYMBIO confirmed the short- and long-term effects and also found a significant improvement in left ventricular ejection fraction among CoQ10 therapy adherents (4).

A meta-analysis involving 13 studies of CoQ10 supplementation with HF confirmed that CoQ10 resulted in ejection fraction improvements among patients with less severe stages of HF, although the authors suggest that studies with more diverse demographics and that refine and compare dose responses are warranted (5). If you have heart failure, you may want to discuss CoQ10 supplementation with your physician.

Iron deficiency challenges

An observational study that followed 753 heart failure patients for almost two years showed that iron deficiency without anemia increased the risk of mortality in heart failure patients by 42 percent (6).

In this study, iron deficiency was defined as a ferritin level less than 100 μg/L (the storage of iron) or, alternately, transferrin saturation less than 20 percent (the transport of iron) with a ferritin level in the range 100–299 μg/L.

The authors conclude that iron deficiency is potentially more predictive of clinical outcomes than anemia, contributes to the severity of HF and is common in these patients. Thus, it behooves us to try to prevent heart failure through dietary changes, including high levels of antioxidants, because it is not easy to reverse the disease. Those with HF should have their ferritin and iron levels checked, for these are correctable.

Based on study results, CoQ10 appears to be a compelling therapy to reduce risk of further complications and potentially death. Consult with your doctor before taking CoQ10 or any other supplements.

References:

(1) cdc.gov. (2) Am J Med. 2013 Jun:126(6):494-500. (3) JACC Heart Fail. 2014 Dec;2(6):641-649. (4) Cardiol J. 2019;26(2):147-156. (5) Am J Clin Nutr. 2013 Feb; 97(2): 268–275. (6) Am Heart J. 2013;165(4):575-582.

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. 

by -
0 158
View the Memorial Parade of Boats before race. Photo by Bob Savage

The 12th annual Village Cup Regatta, a friendly competition between Mather Hospital and the Village of Port Jefferson, will sail with full crews this Saturday, September 11. 

Join Ralph Macchio in supporting a most worthy cause. File photo by Bob Savage

Presented by the Port Jefferson Yacht Club, the Regatta raises funds for Mather’s Palliative Medicine Program and the Lustgarten Foundation, which funds pancreatic cancer research. The event has raised almost $640,500 for the two organizations. Last year’s event was held without crew members due to the pandemic. The event raised $40,000, which was divided between Mather and Lustgarten.

Actor/director and local resident Ralph Macchio will again act as community ambassador for the event. This is the ninth year Macchio has helped to publicize the important work of the two programs funded by the Regatta. Macchio’s wife, Phyllis, is a nurse practitioner in Mather’s Palliative Medicine Program.

The Regatta consists of Yacht Club-skippered sailboats divided into two teams representing Mather Hospital and the Village of Port Jefferson. Employees from the Hospital and Village help crew the boats, which race in one of three classes based on boat size. 

The festivities will begin at Harborfront Park in Port Jefferson Village at 10 a.m., where you can purchase t-shirts signed by Ralph Macchio, along with the event’s commemorative hats, nautical bags and mugs. The Memorial Parade of Boats begins at 11 a.m. at the Port Jefferson Village dock. All sailboats participating in the Regatta will pass by the park dressed in banners and nautical flags on their way out to the racecourse on Long Island Sound.

Following the race, a celebratory Skipper’s Reception and presentation of the Village Cup will take place in a restored 1917 shipyard building that now serves as the Port Jefferson Village Center.

Businesses, organizations and individuals can support the Regatta and the programs it funds by making a donation or purchasing tickets to attend the Skipper’s Reception or view the event on a spectator boat.. Sponsorships also are available. For more information and to purchase tickets please visit http://portjeffersonyachtclub.com/community/village-cup/ or www.facebook.com/villagecupregatta

by -
0 430
Photo from Statepoint

September, which is World Alzheimer’s Month, is an excellent reminder to keep your mind and body healthy through the years. Experts say that doing so can reduce your risk for cognitive decline. Try taking on these new hobbies to keep your mind sharp as you age:

• Cooking: Not only can the development of a new complicated skill such as cooking improve cognitive functions like problem-solving and concentration, but having the ability to create your own nutritious meals at home has the added benefit of being good for brain health. From TikTok tutorials to online classes taught by master chefs, today, there are more avenues for picking up culinary know-how than ever before.

• Music: Learning to play a musical instrument has countless benefits for brain health, helping improve memory, hand-eye coordination and more. It’s also a mood booster, which is important, as depression is considered a risk factor for dementia. Check out instruments designed to build skills quickly. Whether you’re a total novice or taking up the piano after a long hiatus, Casiotone Keyboards, for example, are portable, easy to use and connect to an app that features lessons and more.

• Exercise: The mind-body connection is strong. For ultimate brain health, stay physically active; and if you can do so outdoors, all the better. Research suggests that connecting with nature is good for one’s mental well-being, reducing stress, anxiety and depression. Support your journey with tools that track your activity and inspire you to delve further into adventures, whether that be hiking, fishing or rock climbing. The watches in the Pro Trek line feature Quad Sensor technology to provide you with temperature and barometric pressure so you can keep your eye on the weather conditions while out and about, as well as sunrise and sunset times, an app for anglers and much more.

• Camaraderie: Having an active social life can improve brain function. Unfortunately, if you aren’t proactive about it, there are not always that many opportunities to make new friends in adulthood. Whether it’s a sewing circle or a bowling league, consider joining a club or team for camaraderie and fun.

• Fast fingers: Did you know that you can use your calculator to keep your mind engaged when there’s downtime or you’re on-the-go? Calculator games can build math skills, improve memory and keep your mind nimble.

Just as it is important to maintain physical fitness as you age, it’s also critical to exercise your mind. Stay mentally active by trying new hobbies, building new skills and seeking out new experiences.

by -
0 57
Stock photo

Tropical Storm Ida’s heavy rains may create a breeding ground for the mosquitoes that carry West Nile Virus, health officials warn.

“Following the recent heavy rainfall, we are concerned that standing water and summer temperatures will allow mosquitoes to proliferate,” Gregson Pigott, Suffolk County health commissioner, said in a statement. “While there is no cause for alarm, we ask residents to cooperate with us in our efforts to reduce exposure to West Nile virus and other mosquito-borne diseases.”

As of last week, 92 mosquito samples and four birds had tested positive for West Nile virus. From Aug. 25 to Aug. 26, 21 samples tested positive for the virus.

At least one mosquito from samples collected in Cold Spring Harbor, Huntington Station, Northport, Stony Brook, Port Jefferson Station and Rocky Point tested positive for the virus, according to the Suffolk County Health Department.

Most people infected with West Nile Virus, which was first detected in Suffolk County in 1999, have mild or no symptoms. Some, however, can develop high fever, headaches, neck stiffness, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis, according to the health department.

Over the last 20 years, the number of mosquito samples testing positive for West Nile ranged from a low of eight in 2004 to a high of 295 in 2010, a year that also saw 25 human cases with three deaths.

Pigott urges residents to wear shoes and socks, long pants and long-sleeved shirts when mosquitoes are active. He also suggested using mosquito repellent, while reading and following directions carefully.

The Centers for Disease Control and Prevention recommends repellents containing DEET, oil of lemon eucalyptus, picaridin and IR3535, which can be used on skin and clothing. For children, lower concentrations of DEET are preferable, according to the CDC.

Insect repellents with permethrin should only be used on clothing and not directly on the skin.

Effective screens on windows and doors can keep mosquitoes out of homes and living areas.

Emptying containers that hold water, such as vases, pet water bowls, flowerpot saucers, birdbaths, trash cans and rain barrels can reduce available water sources for mosquitoes to lay their eggs. Scrubbing containers like pet water bowls can remove insect eggs that might otherwise survive.

Adrian Popp, chair of Infection Control at Huntington Hospital, explained that most disease doctors are on the lookout for West Nile infections. He tests everybody with an unexplained fever or other symptoms.

In a typical year, Huntington Hospital sees a few cases of West Nile. So far, Popp said, the hospital hasn’t reported any such illnesses.

“It is hard to say if it will be more prevalent this year since we had only a few cases in New York State so far and it is already the end” of the summer season, Popp wrote in an email.

While Popp said anyone is vulnerable to West Nile Virus if he or she is bitten by a mosquito, most cases are asymptomatic. Fewer than one percent of those who contract West Nile Virus develop more severe symptoms.

For those people who have more severe symptoms, doctors don’t have many tools at their disposal.

“There is no etiologic therapy,” Popp explained in an email. “Therapy is supportive, symptomatic care.”

The county urged residents concerned about West Nile Virus to download a copy of an informational brochure called “Get the Buzz on Mosquito Protection” on www.suffolkcountyny.gov.

by -
0 93
Photo from Stony Brook Medicine

The Rose Caracappa Senior Center, 739 Route 25A, Mt. Sinai, welcomes a Stony Brook Cancer Center mobile mammography van to its parking lot on Friday, Sept. 10 from 9 a.m. to 5 p.m. Screenings are performed by NYS-registered radiologic technologists with advanced training in mammography. The van has a comfortable waiting area, private dressing room and a complete exam room. Mammography images are read by board-certified radiologists at Stony Brook.

Schedule Appointment

  • Call 631-638-4135 to schedule an appointment

Eligibility:

  • Must be female and 40 years of age or older.
  • No mammograms in the past year.
  • Not pregnant or breastfeeding.
  • No implants or breast issues, such as a lump or nipple discharge.
  • Never diagnosed with breast cancer.
  • Office visit within the past year with a gynecologist, primary care physician or internist who is willing to accept the results of the screening.

On the Day of Your Appointment:

  • Please do not wear deodorant, perfume, powders, lotions or creams on the breast area.
  • Please bring your photo ID and insurance card, if insured.

Health Insurance

  • Individuals who do not have health insurance will be processed through the Cancer Services Program of New York, if eligible.

by -
0 90
In recent studies, apples, bananas and pears were shown to reduce COPD. Pixabay photo
Lung health is affected by simple diet and exercise changes

By David Dunaief, M.D.

Dr. David Dunaief

The COVID-19 pandemic has raised many people’s awareness of the importance of lung function. Its consequences are especially severe for those with chronic obstructive lung diseases such as chronic obstructive pulmonary disease (COPD) and asthma, as well as those who smoke and vape.

What can we do to strengthen our lungs? We can improve lung function with simple lifestyle modifications including exercising, eating a plant-based diet with a focus on fruits and vegetables, expanding lung capacity with an incentive spirometer, and quitting smoking and vaping, which damage the lungs (1). Not only people with compromised lungs will benefit; studies suggest everyone will benefit.

COPD and diet

Several studies demonstrate that higher consumption of fiber from plants decreases the risk of COPD in smokers and ex-smokers. Bear with me, because the studies were done with men or women, not both at the same time. In one study of men, for example, results showed that higher fiber intake was associated with significant 48 percent reductions in COPD incidence in smokers and 38 percent incidence reductions in ex-smokers (3). The high-fiber group ate at least 36.8 grams per day, compared to the low-fiber group, which ate less than 23.7 grams per day. Fiber sources were fruits, vegetables and whole grain, essentially a whole foods plant-based diet. The high-fiber group was still below the American Dietetic Association-recommended 38 grams per day. This is within our grasp. 

In another study, women had a highly significant 37 percent decreased risk of COPD among those who consumed at least 2.5 serving of fruit per day compared to those who consumed less than 0.8 servings per day (4). The highlighted fruits shown to reduce COPD in both men and women included apples, bananas, and pears.

Asthma and diet

In a randomized controlled trial of asthma patients, results show that after 14 days those who ate a low-antioxidant diet had less lung function compared to those who ate a high-antioxidant diet (2). Researchers measured lung function with one-second forced expiratory volume (FEV1) and predicted forced vital capacity (FVC). 

Additionally, those who were in the low-antioxidant diet group also had higher inflammation at 14 weeks, as measured using a c-reactive protein (CRP) biomarker. Those who were in the low-antioxidant group also were over two-times more likely to have an asthma exacerbation.

The good news is that the difference in behavior between the high- and low-antioxidant groups was small. The high-antioxidant group had a modest five servings of vegetables and two servings of fruit daily, while the low-antioxidant group ate no more than two servings of vegetables and one serving of fruit daily. 

Carotenoid supplementation, instead of antioxidant foods, made no difference in inflammation. The authors concluded that an increase in carotenoids from diet has a clinically significant impact on asthma and can be seen in a very short period. 

Incentive spirometry

What is an incentive spirometer? It’s a device that helps expand the lungs by inhaling through a tube and causing a ball or multiple balls to rise. This opens the alveoli and may help you breathe better. 

Incentive spirometry has been used for patients with pneumonia, those who have chest or abdominal surgery and those with asthma or COPD, but it has also been useful for healthy participants (5). A small study showed that those who trained with an incentive spirometer for two weeks increased their vital capacity, right and left chest wall motion, and right diaphragm motion. This means it improved lung function and respiratory motion. Participants were 10 non-smoking healthy adults who were instructed to take five sets of five deep breaths twice a day, totaling 50 deep breaths per day. The brands used in the study are inexpensive and easily accessible, such as Teleflex’s Triflo II.

In another small, two-month study of 27 patients with COPD, the incentive spirometer improved blood gasses, such as partial pressure carbon dioxide and oxygen, in COPD patients with exacerbation (6). The authors concluded that it may improve quality of life for COPD patients.  

Exercise

Exercise can have a direct impact on lung function. In a study involving healthy women ages 65 years and older, results showed that 20 minutes of high-intensity exercise three times a day improved FEV1 and FVC, both indicators of lung function, in as little as 12 weeks (7). Participants began with a 15-minute warm-up, then 20 minutes of high-intensity exercise on a treadmill, followed by 15 minutes of cool-down with stretching.

What is impressive is that it was done in older adults, not those in their twenties and not in elite athletes.

Note that you don’t need a treadmill to do aerobic exercise. You can walk up steps or steep hills in your neighborhood, do jumping jacks, or even dance in your living room. Whatever you choose, you want to increase your heart rate and expand your lungs. If this is new for you, consult a physician and start slowly. You’ll find that your stamina improves rather quickly over time.

We all should be working to strengthen our lungs, regardless of COVID-19. This three-pronged approach of lifestyle modifications – diet, exercise and incentive spirometer – can help without expending significant time or expense.

References:

(1) Public Health Rep. 2011 Mar-Apr; 126(2): 158-159. (2) Am J Clin Nutr. 2012 Sep;96(3):534-43.(3)Epidemiology Mar 2018;29(2):254-260. (4)Int J Epidemiol Dec 1 2018;47(6);1897-1909. (5)Ann Rehabil Med. Jun 2015;39(3):360-365. (6)Respirology. Jun 2005;10(3):349-53.(7)J Phys Ther Sci. Aug 2017;29(8):1454-1457. 

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. 

by -
0 78

Catholic Health Services will be offering free health screenings for adults on its outreach bus in the parking lot of Comsewogue Public Library, 170 Terryville Road, Port Jefferson Station on Wednesday, Sept. 8 from 10 a.m. to 2 p.m.

This community health outreach program will provide free blood pressure, cholesterol, body mass index, and glucose screenings; along with patient preventative health education and referrals as needed.

These free health screenings will be administered by a Catholic Health registered nurse. No appointments are necessary, insurance is not required and there are no fees. Open to all 18 years and older.

Questions? Call 631-928-1212.

by -
0 1284
PSMA Riverhead Imaging. Photo from Stony Brook Medicine

According to the American Cancer Society, an estimated one in eight men will be diagnosed with prostate cancer in their lifetimes. Until now, conventional imaging, especially at low PSA (Prostate-Specific Antigen) levels, has not been able to identify the location and extent of the disease in the majority of cases of men with a suspected cancer recurrence. Now, Stony Brook University Cancer Center, in conjunction with Stony Brook Advanced Imaging, is the first on Long Island to offer men with prostate cancer targeted Positron Emission Tomography (PET) imaging with PYLARIFY® (piflufolastat F 18) Injection, a Prostate-Specific Membrane Antigen (PSMA) imaging agent.

PSMA Riverhead Imaging. Photo from Stony Brook Medicine

Backed by the experts and state-of-the-art technology at Stony Brook Advanced Imaging Center, this type of imaging enables visualization of lymph nodes, bone and soft tissue metastasis to determine the presence or absence of recurrent and/or metastatic prostate cancer.

Dr. Dinko Franceschi, Chief of Nuclear Medicine and Director of Clinical PET in the Department of Radiology at the Renaissance School of Medicine, states, “For years, there has not been good imaging modalities for prostate cancer – now we have this tool to see exactly where the tumor is in a patient, which will help in determining the best approach going forward.”

Developed by Lantheus, PYLARIFY® was recently approved by the U.S. Food and Drug Administration (May 2021) as the first commercially available PSMA PET imaging agent for prostate cancer.  Those with suspected metastasis who are candidates for initial definitive therapy or those with suspected recurrence based on elevated serum PSA level are eligible for the scan.

PSMA scans are available at two Stony Brook Medicine imaging centers (Riverhead and Stony Brook) with more locations to follow.

For more information or to make an appointment, visit imaging.stonybrookmedicine.edu. To learn more about Stony Brook Cancer Center and prostate cancer treatment, visit cancer.stonybrookmedicine.edu.

About Stony Brook Medicine:

Stony Brook Medicine integrates and elevates all of Stony Brook University’s health-related initiatives: education, research and patient care. It includes five Health Sciences schools — Dental Medicine, Health Technology and Management, Medicine, Nursing and Social Welfare — as well as Stony Brook University Hospital, Stony Brook Southampton Hospital, Stony Brook Eastern Long Island Hospital, Stony Brook Children’s Hospital and more than 200 community-based healthcare settings throughout Suffolk County. To learn more, visit www.stonybrookmedicine.edu.

About PYLARIFY® 

PYLARIFY® (piflufolastat F 18) injection s a fluorinated small molecule PSMA-targeted PET imaging agent that enables visualization of lymph nodes, bone and soft tissue metastases to determine the presence or absence of recurrent and/or metastatic prostate cancer. For men with prostate cancer, PYLARIFY PET combines the accuracy of PET imaging, the precision of PSMA targeting and the clarity of an F 18 radioisotope5 for superior diagnostic performance. The recommended PYLARIFY dose is 333 MBq (9 mCi) with an acceptable range of 296 MBq to 370 MBq (8 mCi to 10 mCi), administered as a bolus intravenous injection.

by -
0 79

The Town of Smithtown Horizons Counseling & Education Center, in partnership with St. Catherine of Siena Medical Center, will mark International Overdose Awareness Day by holding a free Narcan training event for the community. On Tuesday, August 31st at noon, the Community Action for Social Justice Organization (CASJ) will conduct a free NARCAN® training seminar outdoors under the shaded pool deck at Smithtown Landing Country Club, 495 Landing Avenue, Smithtown.

“This is an invaluable life saving skill for everyone and anyone to learn. Don’t think to yourself, I’ll never need this skill… you simply just never know! Accidental overdoses on prescription drugs can easily happen to an elderly person living alone or to a family member suffering from dementia. Additionally, we’ve been fighting an opioid epidemic for years. The coronavirus pandemic undoubtedly made it more difficult to fight back and get people help. Human beings make mistakes, but they all deserve a second chance… Narcan training is a weapon against this battle… and everyone should arm themselves with this life saving skill.” – Supervisor Ed Wehrheim

St. Catherine of Siena Medical Center and Horizons Counseling & Education Center resource tables will be set up around the training area, filled with invaluable services, information, promotional items and refreshments. Space is limited and on a first come first serve basis. Residents can reserve space by contacting Horizons Counseling & Education Center at (631) 360-7578 via email at [email protected] or register online: (https://events.r20.constantcontact.com/register/eventReg?oeidk=a07eige1kdaaa916e45&oseq=&c=&ch=)  Reservations for training should be made before the end of business on Monday August 30th, 2021.

International Overdose Awareness Day is the world’s largest annual campaign to end overdose, remember without stigma those who have died and acknowledge the grief of the family and friends left behind. It began in 2001, led by Sally J Finn at The Salvation Army in St Kilda, Melbourne. Since then, communities, governments, and organizations work to raise overdose awareness about one of the world’s worst public health crises, and promote action and discussion about evidence-based overdose prevention and drug policy.

About Community Action for Social Justice:

Community Action for Social Justice (CASJ) is a not-for-profit organization that fosters improved health and quality-of-life for Long Islanders impacted by drug use, incarceration, homelessness, and chronic disease through participant-centered services and policy advocacy to reduce  broader social and structural barriers. A vital part of CASJ’s work is their Overdose Prevention Program, which provides free training and naloxone (Narcan) kits, not only at community events, but with individuals and families in the comfort and privacy of their own homes. To learn more visit: https://casj.org/

by -
0 61
Stock photo
Excess fat contributes to increased inflammation

By David Dunaief, M.D.

Dr. David Dunaief

Obesity is an ongoing struggle for many in the United States. If you, like many, put on some extra pounds during the past 18 months, it’s even more concerning.

Obesity is a disease unto itself and is defined by a BMI (body mass index) of >30 kg/m2, but obesity can also be defined by excess body fat, which is more important than BMI.

Poor COVID-19 outcomes have been associated with obesity, especially in the U.S. In a study involving 5700 hospitalized COVID-19 patients in the NYC area, the most common comorbidities were obesity, high blood pressure and diabetes (1). Of those who were hospitalized, 41.7% were obese.

In a study in China, results showed that those who were overweight were 86 percent more likely to have severe COVID-19 pneumonia, and that percentage increases to 142 percent when obesity is reached (2).

In fact, one study’s authors suggested quarantining should be longer in obese patients because of the potential for prolonged viral shedding compared to those in the normal range for weight (3).

And though age is a risk factor for COVID-19, among those younger than 60 and obese, there is a two-times increased risk of being admitted to the hospital, according to a 3,615-patient study at NYU Langone Health (4).

While these studies do not test specifically for the more recent variants, I would expect the results are similar.

Why is risk for severe COVID-19 higher with obesity? 

According to the prevailing theory, obesity may interfere with mechanical aspects of breathing, thus increasing airway resistance and make gas in exchange more difficult in the lung. It may also impede on lung volume by exerting pressure on the lungs and may involve weaker muscles necessary for respiration (5).

Why is excess fat more important than BMI? 

First, some who have elevated BMI may not have a significant amount of fat; they may actually have more innate muscle. More than 25 percent of my patient population is “solidly built,” which means they have greater muscle mass as well as too much excess fat. Visceral fat is the most important, since it’s the fat that lines the organs, including the lungs.

For another, fat cells have adipokines, specific cell communicators found in fat cells that communicate with other fat cells but also other systems such as the brain, immune system, muscles, and liver. Adipokines can be mediators of both inflammation and insulin resistance, according to an endocrinology study (6). In a study of over 4,000 patients with COVID-19, the author suggests that inflammation among obese patients may be an exacerbating factor for hospitalizations and severe illness (7). 

If we defined obesity as being outside the normal fat range – normal ranges are roughly 11-22 percent for men and 22-34 percent for women – then close to 70 percent of Americans are obese.

Inflammation reduction and weight-loss combined

In a randomized controlled trial with 75 participants comparing a plant-based diet to a control diet, there was a greater than 14 lbs. weight reduction and roughly 10 lbs. fat reduction over a 14-week period (8). Of the weight lost, about 70 percent was excess fat. Remember, excess body fat, through adipokines, may be inflammatory and increase the risk of severe COVID-19. 

The weight reduction with a plant-based approach may involve the increase in fiber, reduction in dietary fat and increased burning of calories after the meal, according to Physician’s Committee for Responsible Medicine (PCRM) (9).

You also want a diet that has been shown to reduce inflammation.

We recently published a study involving 16 patients from my clinical practice. It shows that those who ate a whole food plant-based LIFE (low inflammatory foods everyday) diet over a seven-day period had a significant decrease in inflammation measured by hsCRP (high sensitivity c-reactive protein). This occurred in those who completely changed their diets to the LIFE diet, but also occurred in those who simply added a greens and fruit-based smoothie daily to their existing diet (10).

In my practice, I have seen a number of patients lose a substantial amount of weight, but also body fat, over a short period. For instance, a 70-year-old male lost 19 lbs. of weight and 12 lbs. of body fat over a six-week period. His inflammation, which was very high to start, dropped substantially to the border of optimal levels, using hsCRP as the inflammation measurement. This patient and many others have seen tandem reductions in both weight and inflammation. To boot, this was a cardiac patient whose cardiologist had considered a stent, but later said he did not need it after reducing his inflammation.

If the continuing COVID-19 concerns do not convince you that losing excess fat is important, then consider that obesity contributes to, or is associated with, many other chronic diseases like cardiovascular disease, high blood pressure, and high cholesterol, which also contribute to severe COVID-19. Thus, there is an imperative to lose excess body fat.

References:

(1) JAMA. online April 22, 2020. (2) Clin Med (Lond). 2020 Jul; 20(4): e109–e113. (3) Acta Diabetol. 2020 Apr 5: 1–6. (4) Clin Infect Dis. 2020 Jul 28;71(15):896-897. (5) Chron. Respir. Dis. 5, 233–242 (2008). (6) Front Endocrinol (Lausanne). 2013; 4:71. (7) MedRxiv.com. (8) Nutr Diabetes. 2018; 8: 58. (9) Inter Journal of Disease Reversal and Prevention 2019;1:1. (10) Am J of Lifestyle Med. online Oct. 5, 2020.

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. 

Prev1...495051...149Next Page 50 of 149
TBR News Media is your local news and entertainment website.
We provide you with the latest breaking news and information for your community.
Contact us: [email protected]

Most Viewed

©