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Even if you don’t use a salt shaker, you’re likely getting more sodium than the current guidelines. METRO photo
Eating whole foods can improve your odds of victory

By David Dunaief, M.D.

Dr. David Dunaief

We hear a lot about sodium and the importance of limiting your sodium intake. But what if you don’t have a health condition like hypertension? Should you still be concerned? The short answer is, “yes.” Most of us consume far too much sodium, as much at 3,400 mg per day, without even trying (1). Even if we don’t have hypertension, the impact of sodium on our health can be dramatic.

Sodium is everywhere, including in foods that don’t taste salty. Bread products are among the worst offenders. Other foods with substantial amounts of sodium include cold cuts and cured meats, cheeses, pizza, poultry, soups, pastas, sauces and, of course, snack foods. Processed foods and those prepared by restaurants are where much of our consumption occurs (2).

On the flip side, only about two percent of people get enough potassium from their diets (3). According to the National Institutes of Health, adequate intake of potassium is between 2600mg and 3400mg for adult women and men, respectively.

Why do we compare sodium and potassium intakes?

A high sodium-to-potassium ratio increases the risk of cardiovascular disease by 46 percent, according to a study that looked at more than 12,000 Americans over almost 15 years (4). In addition, both may have significant impacts on blood pressure and cardiovascular disease. To improve our overall health, we need to shift the sodium-to-potassium balance so that we consume more potassium and less sodium. And if you struggle with high blood pressure, this approach could help you win the battle.

Can sodium intake be too low?

Before we dive in too far, let’s address an “elephant in the room.” I’ve read several commentaries where experts warn that too-low sodium levels can be a problem. While this is true, it’s quite rare, unless you take medications or have a health condition that depletes sodium. We hide sodium everywhere, so even if you don’t use a salt shaker, you’re likely getting more sodium than the current guidelines.

Why lower your sodium consumption?

Two studies illustrate the benefits of reducing sodium in high blood pressure and normotensive (normal blood pressure) patients, ultimately preventing cardiovascular disease, including heart disease and stroke.

The first used the prestigious Cochrane review to demonstrate that blood pressure is reduced by a significant mean of −4.18 mm Hg systolic (top number) and −2.06 mm Hg diastolic (bottom number) involving both normotensive and hypertensive participants (5). When looking solely at hypertensive patients, the reduction was even greater, with a systolic blood pressure reduction of −5.39 mm Hg and a diastolic blood pressure reduction of −2.82 mm Hg.

This was a meta-analysis that evaluated data from 34 randomized clinical trials, totaling more than 3,200 participants. Salt reduction from 9-to-12 grams per day to 5-to-6 grams per day had a dramatic effect. The researchers believe that the more we reduce the salt intake, the greater the effect of reducing blood pressure. The authors recommend further reduction to 3 grams per day as a long-term target for the population and concluded that the effects on blood pressure will most likely result in a decrease in cardiovascular disease.

In the second study, a meta-analysis of 42 clinical trials, there was a similarly significant reduction in both systolic and diastolic blood pressures (6). This study included both adults and children. Both demographics saw a reduction in blood pressure, though the effect was greater in adults. Interestingly, an increase in sodium caused a 24 percent increased risk of stroke incidence but, more importantly, a 63 percent increased risk of stroke mortality. The risk of mortality from heart disease was increased alongside an increase in sodium, as well, by 32 percent.

Is potassium consumption important?

In a meta-analysis involving 32 studies, results showed that as the amount of potassium was increased, systolic blood pressure decreased significantly (7). When foods containing 3.5 to 4.7 grams of potassium were consumed, there was an impressive −7.16 mm Hg reduction in systolic blood pressure with high blood pressure patients. Anything more than this amount of potassium did not have any additional benefit. Increased potassium intake also reduced the risk of stroke by 24 percent. This effect was important.

The reduction in blood pressure was greater with increased potassium consumption than with sodium restriction, although this was not a head-to-head comparison. The good news is that potassium is easily attainable; it’s found in many whole foods and is richest in fruits, vegetables, beans and legumes.

The bottom line: decrease your sodium intake by almost half and increase potassium intake from foods. Lowering sodium intake may have far-reaching benefits, and it is certainly achievable. First, consume less and give yourself a brief period to adapt — it takes about six weeks to retrain your taste buds, once you cut your sodium. You can also improve your odds by increasing your dietary potassium intake, striking a better sodium-to-potassium balance.

References:

(1) Dietary Reference Intakes for Sodium and Potassium. Washington (DC): National Academies Press (US); 2019 Mar. (2) www.cdc.gov. (3) www.nih.gov. (4) Arch Intern Med. 2011;171(13):1183-1191. (5) BMJ. 2013 Apr 3;346:f1325. (6) BMJ. 2013 Apr 3;346:f1326. (7) BMJ. 2013; 346:f1378.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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From left, Anthony Comerford, VP Health Services; Kathy Koutouvidis, RN, Assistant Director, Nursing; Patti Gallagher, Director, Environmental Services; Dawn Flowers-Leib, Director, Admissions; Richelle Rugolo, RN, Director, Nursing; and Bob Caulfield, President and CEO, Jefferson’s Ferry Life Plan Community.

For the fifth year in a row, Jefferson’s Ferry Life Plan Community of South Setauket has earned Pinnacle Quality Insight’s Customer Experience Award for outstanding resident satisfaction and overall achievement in the health care industry.  

This award recognizes the dedication of the staff of The Vincent Bove Health Center at Jefferson’s Ferry in providing “Best in Class” service in Skilled Nursing.  Jefferson’s Ferry’s health center scored in the top 15% of skilled nursing facilities nationwide over a 12-month period of study, excelling in  Nursing Care, Cleanliness, Individual Needs, Recommendation to Others, Activities, Admission Process, Safety & Security, and Overall Customer Experience.

“Since our founding more than 20 years ago as Long Island’s first Continuing Care Retirement Community, Jefferson’s Ferry has been committed to providing the highest quality experience in a community setting that promotes dignity, privacy, individuality and independence for every resident,” said Jefferson’s Ferry President and CEO Bob Caulfield. “The Pinnacle Award is a direct reflection of the outstanding work that our employees perform every day. It’s always gratifying to know that our residents recognize our dedication with this vote of confidence.” 

Over the course of 2022, a sampling of residents of the Vincent Bove Health Center and their families participated in monthly telephone interviews that asked open-ended questions to rate their experiences in specific categories.    

Every month, Jefferson’s Ferry staff evaluated the results from the interviews to gain a better understanding of resident needs and make improvements when necessary. 

“In addition to the high marks our residents and their families give us in the Pinnacle survey, they also recommend Jefferson’s Ferry to their friends and family,” added Anthony Comerford, Vice President of Health Service. “Our staff and residents form close relationships based on mutual respect, trust, and quality care.” 

“While we don’t come to work looking to win awards, we always do our very best for our residents and families,” concluded Caulfield. “Our goal is always to provide the people who call Jefferson’s Ferry  home with the means and peace of mind to live their best life here.  It is especially meaningful to know that we are consistently hitting the mark, meeting or exceeding the best standards or practices within our industry.  It’s the people who live and work here that make Jefferson’s Ferry the truly special and vibrant community we know so well.”  

For more information visit www.jeffersonsferry.org

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Pictured from left, Jackie Frank, RN; Dr. Salim Matar M.D., F.A.C.S., Cari Cioffi, Carly Montalto, PJCC Past President Mary Joy Pipe; PJCC Third Vice President Douglas Quattrock and PJCC Past President Dr. Suzanne Velazquez. Photo from PJCC

The Greater Port Jefferson Chamber of Commerce (PJCC) held a ribbon cutting welcoming new chamber member Long Island Sinus Institute on March 30. 

Located at 640 Belle Terre Rd. Bldg. C, Port Jefferson, the staff of ENT specialists offers complete, personal care plans to treat symptoms due to a variety of ear, nose and throat-related conditions including balloon sinuplasty (balloon sinus dilation) for recurrent sinus infections along with nasal allergies, nasal obstruction, nasal polyps, nosebleeds, recurrent sore throats, diagnosis and treatment of sleep apnea, upper airway obstruction and snoring.

“The  Greater Port Jefferson Chamber of Commerce welcomes Dr. Nahum Archin and Dr. Salim Matar and staff to the chamber! Their specialized medical expertise with the latest techniques in balloon sinuplasty surgery will provide needed services to our community. The Chamber wishes them well and much success,” said Barbara Ransome, Director of Operations at the PJCC. For more information, call 631-928-7750 or visit www.longislandsinusinstitute.com.

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Photo by Mary Pahlke/Pixabay

By Fr. Francis Pizzarelli

Father Frank Pizzarelli

Every newspaper, every news channel, no matter what their politics are talking about the serious concerns around the mental health of the young people in our country.

The mental health of our youth is on the verge of becoming, if it has not already, a national health epidemic!

Social media is out of control. The pandemic has not helped this national crisis. Candidly, it has intensified it. So, what do we do? First, we need to destigmatize any kind of mental health and substance use disorders. We have to have the courage to act bravely to provide competent, cost-effective treatment services for mental health and addictive health.

Telehealth is a great resource but is already overbooked and is geared more to working with the middle/upper class. They have waiting lists that are endless. Private practice is overloaded as well. The clinics of yesteryear who are capable of reaching out to the underserved need to be resurrected and properly staffed.

Our local hospitals need additional funds to build on the excellent services that already exist but do not meet the epidemic need. Mental health must become a priority; too many young people are toying with suicide. Most don’t want to die they just want the pain and anguish to stop.

Too often that pain is intensified due to our social media platforms, which can be unbearable triggers for those who are already struggling with self-esteem and self-worth. We need to challenge our schools to be more effective in teaching better coping skills and also creating more safe places where students can go and talk without fear of judgment, shame, and guilt.

Most school districts should consider increasing their social work staff. If they don’t have any social workers on their staff, they should consider hiring competent social workers with plans to better serve our children who are at risk. We need more of a collaborative effort between mental health staff faculty, administrators and support staff. This kind of collaboration really does make a difference.

TJ was 16; he was shy to begin with. The pandemic made him even more self-conscious and shy. His only outlet was social media. When given the freedom to go out, he stayed in and spent his life on social media. He was a good student, a good young man at home. No one really knew how addicted he had become to social media. He had joined a growing number of invisible young people who are in so much pain and are so closed that they are falling between the cracks.

We need to stop talking and need to think outside the box. We need to demand funding that will allow us to create life-giving opportunities for all of our young people to build their self-worth, their self-confidence and their self-value so that they will know they really matter and can make a difference that counts!

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

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METRO photo
Diet and exercise together are the key to success

By David Dunaief, M.D.

Dr. David Dunaief

If you suffer from osteoarthritis, you know it can affect your quality of life and make it difficult to perform daily activities. Osteoarthritis (OA) most often affects the knees, hips and hands and can affect your mood, mobility, and sleep quality.

Common first-line medications that treat arthritis pain are acetaminophen and nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen. Unfortunately, these medications have side effects, especially with long-term use. Also, while they might relieve your immediate symptoms of pain and inflammation, they don’t slow osteoarthritis’ progression.

Fortunately, there are approaches you can use to ease your pain without reaching for medications. Some can even help slow the progression of your OA or even reverse your symptoms.

What role does weight play?

Weight management is a crucial component of any OA pain management strategy. In a study involving 112 obese patients, those who lost weight reported easing of knee symptoms (1). Even more exciting, the study authors observed disease modification, with a reduction in the loss of cartilage volume around the medial tibia. Those who gained weight saw the opposite effect.

The relationship was almost one-to-one; for every one percent of weight lost, there was a 1.2 mm3 preservation of medial tibial cartilage volume, while the opposite occurred when participants gained weight. A reduction of tibial cartilage is often associated with the need for a knee replacement.

Does vitamin D help?

In a randomized controlled trial (RCT), vitamin D provided no OA symptom relief, nor any disease-modifying effects (2). This two-year study of almost 150 men and women raised blood levels of vitamin D on average to 36 ng/ml, which is considered respectable. Researchers used MRI and X-rays to track their results.

In another study of 769 participants, ages 50-80, researchers found that low vitamin D levels – below 25 nmol/l led to increased OA knee pain over the five-year study period and hip pain over 2.4 years (3). The researchers postulate that supplementing vitamin D might reduce pain in those who are deficient, but that it will likely have no effect on others.

How does dairy factor into OA?

With dairy, specifically milk, there is conflicting information. Some studies show benefits, while others show that it may contribute to the inflammation that makes osteoarthritis pain feel worse.

In the Osteoarthritis Initiative study, researchers looked specifically at joint space narrowing that occurs in those with affected knee joints (4). Results showed that low-fat (1 percent) and nonfat milk may slow the progression of osteoarthritis in women. Compared to those who did not drink milk, patients who did saw significantly less narrowing of knee joint space over a 48-month period.

The result curve was interesting, however. For those who drank from fewer than three glasses a week up to 10 glasses a week, the progression of joint space narrowing was slowed. However, for those who drank more than 10 glasses per week, there was less beneficial effect. There was no benefit seen in men or with the consumption of higher fat products, such as cheese or yogurt.

However, the study was observational and had significant flaws. First, the 2100 patients were only asked about their milk intake at the study’s start. Second, patients were asked to recall their weekly milk consumption for the previous 12 months before the study began — a challenging task.

On the flip side, a study of almost 39,000 participants from the Melbourne Collaborative Cohort Study found that increases in dairy consumption were associated with increased risk of total hip replacements for men with osteoarthritis (5).

Getting more specific, a published analysis of the Framingham Offspring Study found that those who consumed yogurt had statistically significant lower levels of interleukin-6 (IL-6), a marker for inflammation, than those who didn’t eat yogurt, but that this was not true with milk or cheese consumption (6).

Would I recommend consuming low-fat or nonfat milk or yogurt? Not necessarily, but I might not dissuade osteoarthritis patients from yogurt.

Does exercise help with OA pain?

Diet and exercise trumped the effects of diet or exercise alone in a well-designed study (7). In an 18-month study, patients with osteoarthritis of the knee who lost at least 10 percent of their body weight experienced significant improvements in function and a 50 percent reduction in pain, as well as reduction in inflammation. This was compared to those who lost a lower percent of their body weight.

Researchers used biomarker IL6 to measure inflammation. The diet and exercise group and the diet-only group lost significantly more weight than the exercise-only group, 23.3 pounds and 19.6 pounds versus 4 pounds. The diet portion consisted of a meal replacement shake for breakfast and lunch and then a vegetable-rich, low-fat dinner. Low-calorie meals replaced the shakes after six months. The exercise regimen included one hour of a combination of weight training and walking “with alacrity” three times a week.

To reduce pain and possibly improve your OA, focus on lifestyle modifications. The best effects shown are with weight loss and with a vegetable-rich diet. In terms of low-fat or nonfat milk, the results are controversial, at best. For yogurt, the results suggest it may be beneficial for osteoarthritis, but stay on the low end of consumption, since dairy can increase inflammation.

References:

(1) Ann Rheum Dis. 2015 Jun;74(6):1024-9. (2) JAMA. 2013;309:155-162. (3) Ann. Rheum. Dis. 2014;73:697–703. (4) Arthritis Care Res online. 2014 April 6. (5) J Rheumatol. 2017 Jul;44(7):1066-1070. (6) Nutrients. 2021 Feb 4;13(2):506. (7) JAMA. 2013;310:1263-1273.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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Facebook photo

By Nancy Burner Esq.

Nancy Burner, Esq.

The Medicare program is administered jointly by the state and federal government. Medicare is available to adults 65 years of age and older, or to anyone under the age of 65 who is entitled to Social Security Disability. 

Medicare provides varying levels of medical coverage, depending on the plan you have. Medicare Part A and Part B, two of the more basic plans, provide coverage for hospitalization stays, rehabilitation, physical therapy, routine doctor visits, and medical equipment. Medicare Part A will also cover the cost of hospice care with a terminal diagnosis of less than 6 months. 

It is important to note that Medicare will not pay for long term services in a facility or services received at home on a long term basis. For example, if you fall and require surgery, you may need rehabilitation in a facility before able to safely return home. In this case, as long as all requirements are met following the hospital stay, Medicare Part A will cover the full cost of the first 20 days in a rehabilitation facility. For days 21-100, there is a co-pay per day if the patient continues to need rehabilitation services. 

If you have a supplemental insurance policy or commonly referred to as a “gap” policy, this may help ease the cost of the daily out of pocket co-pays. After Medicare stops paying, the full cost of the nursing home falls on the patient. This can cost can be upwards of $600 per day.

As you can see, coverage for rehabilitation under Medicare Part A is intended to be short-term. The goal is improvement of acute conditions through rehabilitation and skilled nursing care. While given up to 100 days, patients rarely qualify for this full amount. After admittance to a facility, the patient is evaluated periodically. Once the facility determines that the patient no longer needs skilled care, coverage under the Medicare program ends.

The most important piece to understand is the difference between skilled care and custodial care. Medicare does not cover custodial care. There are many circumstances where the patient does not fall into the category of needing rehabilitative or skilled care, but the family cannot bring their loved one home safely. Medicare does not pay for time to set up a discharge plan. Once Medicare terminates coverage, the patient needs to return to the community or start privately paying for care.

As you enter the arena of Medicare and with unpredictable times, education is key. It is important to meet with your Elder Law attorney to discuss future care plans and options for aging in place successfully.

Nancy Burner, Esq. is the founder and managing partner at Burner Law Group, P.C with offices located in East Setauket, Westhampton Beach, New York City and East Hampton.

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Author Janet Werner, left, and artist Kyle Horne display their finished book, ‘A Pear in an Apple Tree: A Journey with Multiple Sclerosis.’ Photo courtesy Kyle Horne

One of TBR News Media’s very own recently embarked on a life-changing collaboration with a former educator. 

Kyle Horne, a local artist and frequent contributor of political cartoons and editorial illustrations to our newspapers, has partnered with his former teacher, Janet Werner, to create a book about multiple sclerosis. Together, they tell a moving story of overcoming adversity, revealing a powerful, enduring bond between a student and teacher.

A journey with MS

Werner was diagnosed with multiple sclerosis, commonly known as MS, in 1986. At the onset of her symptoms, she recalled a feeling of numbness in her legs and overwhelming fatigue.

“I actually took off for two weeks from work that first year and just slept,” she said. “I got an MRI at the time, and it showed plaque in the brain, which is white lesions. Depending upon where these white lesions are seen in the brain, it could affect your mobility, cognition and eyesight.”

As the years advanced, Werner’s symptoms gradually progressed. During a startling incident one morning, she temporarily lost her eyesight and hearing completely. “What seemed like hours was about 20 minutes,” she said. “I was terrified because it had never happened before.”

Nearly four decades after her initial diagnosis, Werner explained she is “doing pretty well” despite the heightening symptoms with each passing year. She said managing the symptoms requires plenty of rest and an upbeat mentality.

With husband Ernest, “we try to get some exercise, eat correctly and just keep a positive frame of mind,” she said. “Of course, life is very stressful but we try to be positive.”

‘A Pear in an Apple Tree’

Over several years, Werner wrote “A Pear in an Apple Tree: A Journey with Multiple Sclerosis,” saying she was motivated to write the book for various reasons. 

Among them, she noted a lack of public understanding surrounding MS and its symptoms. She also wanted to share her story with those experiencing MS, preparing them for the path ahead and informing them that they are not alone.

“Sometimes with any challenge in your life, you feel like you’re the only one who has this specific condition or challenge, whether it’s MS or cancer and you kind of hide away from the rest of the world,” she said. “That’s not good to do that. I wanted the ‘MSers’ to feel that we’re in this together.”

Werner recalled the moment that gave the book its name. She said she was eating dinner with her husband, struggling with her symptoms that day, when she blurted out, “I feel like a pear in an apple tree, kind of out of place.”

Despite the numerous challenges through the years, Werner said she wrote the book to let others know they have a place with an MS community that also understands their struggles.

A dynamic team

‘You have to educate yourself about the disease and how it affects your body. And then learn to adapt.’

— Janet Werner

The collaboration between Werner and Horne has been decades in the making. A graduate of Deer Park High School, Horne was her student and a member of the school’s Students Against Destructive Decisions Club, which Werner had advised.

“He would invite me to some of his book signings and art shows, and we kept in close contact over the years,” she said. “When I was doing this book, I immediately thought of him because I loved his artwork.”

Horne described the early stages of preparing the book with his former teacher. He was eager to sign onto the project. 

“She came to me with this idea for a book dealing with MS and how it affects her,” Horne said. Although managing symptoms “can be difficult, those challenges have been very helpful in developing her into the person she is today.”

Along with the cover and back cover, Horne prepared several illustrations throughout the book, tying into the themes of each of its chapters. Together, Werner and Horne developed the characters of Ned and Nancy Neuron.

Through the illustrations he prepared for the book, Horne said he learned much about Werner and her experiences with MS, describing a sense of growth and mutual understanding forged throughout their creative journey together.

“I don’t have MS, but I’m able to sympathize more with Janet and the struggles that she’s had,” the artist said. “She has a very strong spirit when it comes to this.”

An optimistic future

Following the success of their first collaboration, Werner and Horne are already working on the next project, a coloring book that adds an interactive component to the story of Ned and Nancy Neuron.

Werner said she remains “very hopeful” that researchers will soon discover a cure for MS. Analyzing the scope of scientific investigation into the condition, she said there is considerable overlap between ongoing MS research and similar autoimmune diseases.

“Research that’s being conducted for, say, AIDS or lupus is also being conducted for MS,” she said. “Stony Brook [University] has an MS center, and their research is going on at a rapid rate. So I am so hopeful.”

Despite the decades she has spent with MS, Werner shares a message of resolve in the face of hardship.

“I think you have to keep fighting,” she said. “You cannot give up. If you’re faced with a challenge, you have to educate yourself about the disease and how it affects your body. And then learn to adapt.”

Horne said the collaboration with Werner has been a personal experience as well. Learning about MS, he said, has informed his outlook on his own life.

“I have a condition known as ulcerative colitis, also known as Crohn’s disease,” Horne said. “Understanding the perspective of another chronic illness, and from a different person, has come to help with my own process and working through my own things.”

He added, “When it comes to something like this it can be very scary at times, but it also can be very rewarding knowing the perseverance of getting through a struggle like that.”

To learn more about MS, visit www.nationalmssociety.org. To purchase “A Pear in an Apple Tree,” visit www.allbook-books.com.

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By focusing on developing heart-healthy habits, we can improve the likelihood that we will be around for a long time. METRO photo
Modest dietary changes can have a big impact

By David Dunaief, M.D.

Dr. David Dunaief

With all of the attention on infectious disease prevention these past two years, many have lost sight of the risks of heart disease. Despite improvements in the numbers in recent years, heart disease in the U.S., making it the leading cause of death (1).

I have good news: heart disease is on the decline in the U.S. due to a number of factors, including better awareness, improved medicines, earlier treatment of risk factors and lifestyle modifications. We are headed in the right direction, but we can do better. It still underpins one in four deaths, and it is preventable.

Manage your baseline risks

Significant risk factors for heart disease include high cholesterol, high blood pressure and smoking. In addition, diabetes, excess weight and excessive alcohol intake increase your risks. Unfortunately, both obesity and diabetes are on the rise. For patients with type 2 diabetes, 70 percent die of cardiovascular causes (2).

Inactivity and the standard American diet, rich in saturated fat and calories, also contribute to atherosclerosis, fatty streaks in the arteries, the underlying culprit in heart disease risk (3).

Another potential risk factor is a resting heart rate greater than 80 beats per minute (bpm). In one study, healthy men and women had 18 and 10 percent increased risks of dying from a heart attack, respectively, for every increase of 10 bpm over 80 (4). A normal resting heart rate is usually between 60 and 100 bpm. Thus, you don’t have to have a racing heart rate, just one that is high-normal. All of these risk factors can be overcome.

How does medication lower heart disease risk?

Cholesterol and blood pressure medications have been credited to some extent with reducing the risk of heart disease. Unfortunately, according to 2018 National Health and Nutrition Examination Survey (NHANES) data, only 43.7 percent of those with hypertension have it controlled (5). While the projected reasons are complex, a significant issue among those who are aware they have hypertension is a failure to consistently take prescribed medications, or medication nonadherence.

Statins also have played a key role in primary prevention. They lower lipid levels, including total cholesterol and LDL (“bad” cholesterol) but they also lower inflammation levels that contribute to the risk of cardiovascular disease. The JUPITER trial showed a 55 percent combined reduction in heart disease, stroke and mortality from cardiovascular disease in healthy patients — those with a slightly elevated level of inflammation and normal cholesterol profile — with statins.

The downside of statins is their side effects. Statins have been shown to increase the risk of diabetes in intensive dosing, when compared to moderate dosing (6).

Unfortunately, many on statins also suffer from myopathy (muscle pain). I have had a number of patients who have complained of muscle pain and cramps. Their goal is to reduce and ultimately discontinue their statins by following a lifestyle modification plan involving diet and exercise. Lifestyle modification is a powerful ally.

What lifestyle changes help minimize heart disease?

The Baltimore Longitudinal Study of Aging, a prospective (forward-looking) study, investigated 501 healthy men and their risk of dying from cardiovascular disease. The authors concluded that those who consumed five servings or more of fruits and vegetables daily with <12 percent saturated fat had a 76 percent reduction in their risk of dying from heart disease compared to those who did not (7). 

The authors theorized that eating more fruits and vegetables helped to displace saturated fats from the diet. These results are impressive and, to achieve them, they only required a modest change in diet.

The Nurses’ Health Study shows that these results are also seen in women, with lifestyle modification reducing the risk of sudden cardiac death (SCD). Many times, this is the first manifestation of heart disease in women. The authors looked at four parameters of lifestyle modification, including a Mediterranean-type diet, exercise, smoking and body mass index. The decrease in SCD that was dose-dependent, meaning the more factors incorporated, the greater the risk reduction. SCD risk was reduced up to 92 percent when all four parameters were followed (8). Thus, it is possible to almost eliminate the risk of SCD for women with lifestyle modifications.

How can you monitor your heart disease risk?

To monitor your progress, cardiac biomarkers are telling, including inflammatory markers like C-reactive protein, blood pressure, cholesterol and body mass index. 

In a cohort study of high-risk participants and those with heart disease, patients implemented extensive lifestyle modifications: a plant-based, whole foods diet accompanied by exercise and stress management (9). The results showed an improvement in biomarkers, as well as in cognitive function and overall quality of life. Most exciting is that results occurred over a very short period to time — three months from the start of the trial. Many of my patients have experienced similar results.

Ideally, if a patient needs medications to treat risk factors for heart disease, it should be for the short term. For some patients, it may be appropriate to use medication and lifestyle changes together; for others, lifestyle modifications may be sufficient, as long as patient takes an active role.

By focusing on developing heart-healthy habits, we can improve the likelihood that we will be around for a long time.

References:

(1) cdc.gov/heartdisease/facts. (2) Diabetes Care. 2010 Feb; 33(2):442-449. (3) Lancet. 2004;364(9438):93. (4) J Epidemiol Community Health. 2010 Feb;64(2):175-181. (5) Hypertension. 2022;79:e1–e14. (6) JAMA. 2011;305(24):2556-2564. (7) J Nutr. March 1, 2005;135(3):556-561. (8) JAMA. 2011 Jul 6;306(1):62-69. (9) Am J Cardiol. 2011;108(4):498-507.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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Tenzin Tanaka playing on a swing set at his mother’s home. Photo by Samantha Blandi

Port Jefferson Moose Lodge, 37 Crystal Brook Hollow Road, Mt. Sinai hosts a Comedy Show fundraiser by the Terryville Road PTA for Port Jefferson Station 8-year-old Tenzin Tanaka who is battling leukemia on Sunday, March 26 at 4 p.m. (Doors open at 2:30 p.m.) with comedians John Butera, Chris Roach, Dan LaRocco, Rich Walker and Fat Jay.  With 50/50 raffle auction. Mature audiences only. $30 per person, $50 per couple. For tickets, please call 516-662-0931.

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File photo/TBR News Media

Mather Hospital in Port Jefferson has received a 2023 Outstanding Patient Experience Award™ from Healthgrades. This distinction places Mather Hospital among the top 10 percent of hospitals nationwide for patient experience, according to Healthgrades, the leading marketplace that connects people with the right doctor and hospital. Mather Hospital has received the Outstanding Patient Experience Award for three consecutive years (2021-2023). 

The award recognizes hospitals that provide an overall outstanding patient experience and is based on ten measures related to doctor and nurse communication, hospital cleanliness and noise levels, and medication and post-discharge care instructions using data from surveys of the hospital’s own patients. Patient experience is the sum of all interactions, shaped by a healthcare organization’s culture, that influence patients’ perceptions across the continuum of care.

“It is our goal at Mather to constantly evaluate and improve every aspect of our patients’ experience from the moment they walk through our doors,” said Executive Director Kevin McGeachy. “This applies not only to the outstanding clinical care they receive but everything from the quality of the food to the cleanliness of their rooms. I am proud of our entire team for this recognition for the third consecutive year.”

 Earlier this year, Mather also received Healthgrades 2023 America’s 250 Best Hospitals Award™. In addition, Healthgrades awarded Mather the 2023 America’s 100 Best Hospitals for Gastrointestinal Surgery Award™, the 2023 Gastrointestinal Care Excellence Award™, the 2023 Gastrointestinal Surgery Excellence Award™, the 2023 Critical Care Excellence Award™.  Mather also received the Pulmonary Care Excellence Award™ for an 8th consecutive year (2016-2023) and the Bariatric Surgery Excellence Award™ for a fifth year in a row (2019-2023).  

For this annual analysis, Healthgrades evaluated 3,138 hospitals that submitted at least 100 patient experience surveys to the Centers for Medicare and Medicaid Services, covering admissions from January 2021 through December 2021. Of those hospitals evaluated, 419 hospitals outperformed their peers – based on their patients’ responses – to achieve this award.

Healthgrades evaluates performance by applying a scoring methodology to ten patient experience measures, using data collected from HCAHPS survey of the hospital’s own patients. 

Survey questions focus on patients’ perspectives of their care in the hospital, from cleanliness and noise levels in patient rooms to medication explanations and hospital staff responsiveness to 

patients’ needs. The measures also include whether a patient would recommend the hospital to friends or family and their overall rating of the hospital.

“We applaud all recipients of the Healthgrades 2023 Outstanding Patient Experience Award for putting patient experience front and center within their organizations,” said Brad Bowman, MD, Chief Medical Officer and Head of Data Science at Healthgrades. “We commend these hospitals for their ongoing commitment to prioritizing an exceptional patient experience, while ensuring the health and safety of their patients.”

Consumers can visit healthgrades.com for more information on how Healthgrades measures hospital quality and access the complete methodology here. An easy-to-understand overview of Healthgrades’ complete patient experience methodology is also available here.

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