New York Imaging Specialists has announced that board-certified radiologist Matthew Comito, MD, has been appointed Chief Radiology Officer.“Dr. Comito has the administrative, scientific, clinical, leadership, and visionary skills needed to move theDepartment of Radiology forward,” said Jeff Vacirca, MD, CEO.
NY Imaging Specialists offers advanced medical imaging services, including MRI, CT, PET/CT, ultrasound, mammography, interventional radiology, and more. Under his leadership, Dr. Comito will oversee all aspects of radiologic services, including diagnostic imaging, medical imaging, and nuclear medicine, while maintaining the center’s high-quality standards and optimizing workflows and efficiency.
“It is an honor to take on this position as Chief Radiology Officer,” Dr. Comito said. “I am privileged to work with a team of outstanding radiologists, technologists, and administrators. I look forward to supporting the continued rapid growth of NY Imaging while making expert patient care our main priority.”
Northwell Health has announced the opening of a $1.5 million, 4,000-square-foot multidisciplinary practice at 222 Middle Country Road in Smithtown. The Northwell Health Physician Partners office, part of an existing office building, will provide both primary care services as well as several other specialties.
The third-floor office will house three internal medicine physicians, rheumatology, gastroenterology, cardiology, surgical oncology and dermatology. The space will include 10 exam rooms. The three internal medicine physicians are Claude Bridges, MD, Berta Kadosh, DO and Deborah Weiss, MD.
“With this opening Northwell continues our ongoing expansion of delivering high-quality medical care in Suffolk County,” said Mark Talamini, MD, MBA, FACS, senior vice president and executive director of Northwell Health Physician Partners. “It also reaffirms our commitment to providing easy access to a range of different services, more quickly in the neighborhoods in which our patients live and work.”
The specialists complement an existing Physician Partners practice already in the building catering to urology, colon and rectal surgery, obstetrics and gynecology, pediatrics, labs and orthopedics.
“Northwell is extremely excited to open this beautiful destination practice,” said Joseph Baglio, senior vice president of Eastern Region Ambulatory Services at Northwell Health. “This location is another demonstration of Northwell’s commitment to integrated, multidisciplinary, care within the communities we serve.”
Dr. Arif Ahmad, St. Charles and St. Catherine of Siena Acid Reflux and Hiatal Hernia Centers of Excellence Director Photo courtesy of Catholic Health
Catholic Health is expanding its service offerings with the opening of the Acid Reflux and Hiatal Hernia Centers of Excellence at St. Charles Hospital in Port Jefferson and St. Catherine of Siena Hospital in Smithtown. The Centers will offer minimally invasive surgical procedures as a permanent solution for acid reflux and repair of hiatal hernia.
Heartburn and gastroesophageal reflux disease (GERD), also known as acid reflux, is a chronic condition affecting 20 percent of people in the United States. Common symptoms include acid reflux, heartburn, nausea, persistent regurgitation, difficulty swallowing, chronic cough and chest pain.
“We are delighted to provide this much-needed service in our community for those who are suffering from chronic heartburn and acid reflux, looking for a long-term solution,” said St. Charles and St. Catherine of Siena President James O’Connor. “Our goal is to improve the quality of life for patients suffering from heartburn and GERD, with an individualized treatment plan and successful outcome.”
“Many patients want to eliminate dependence on medications and are concerned about long-term side effects,” said St. Charles and St. Catherine of Siena Acid Reflux and Hiatal Hernia Centers of Excellence Director Arif Ahmad, MD. “Most patients continue to regurgitate in spite of medications. Minimally invasive surgical techniques are safe alternatives that should be considered.”
For more information, call 631-474-6808 for St. Charles Hospital and 631-862-3570 for St. Catherine of Siena Hospital.
The number of people battling significant symptoms from the flu and respiratory syncytial virus has been coming down since its peak in January, as these infections have run their course.
“This year, we experienced the most severe flu and RSV waves in decades, and our COVID wave wasn’t small either,” said Sean Clouston, associate professor of Public Health at Stony Brook University.
The number of these illnesses was high as people no longer wore masks in places like schools and after people experienced lower-than-usual illnesses in the months before the mask mandate was lifted, creating fertile ground for viruses to spread.
“The most likely reason that the current flu and RSV seasons have improved is that we have had such a bad season earlier on that we have hit a natural ceiling on the ability for these diseases to successfully infect more people,” Clouston said in an email.
As for COVID-19, the numbers of people who have developed significant illnesses has continued to decline as well, through a combination of the natural immunity people have after their bodies successfully fought off the infection and from the protection offered by the vaccine and boosters.
Doctors added that the vaccine and natural immunity hasn’t prevented people from getting infected, but they have helped people avoid severe and potentially life-threatening symptoms.
“All these people who run around saying, ‘My vaccine isn’t working because I got reinfected,’ are missing the point,” said Dr. Bettina Fries, chief of the Division of Infectious Diseases at Stony Brook Medicine. “It is working. It doesn’t protect you from infection, but [it does prevent] a bad outcome.”
Indeed, during the most recent COVID surge during the winter, Fries said the hospital continued to care for patients, most of whom recovered.
Vaccine timing
Amid discussions from the Centers for Disease Control and Prevention and health organizations throughout the state and country about the timing of future booster shots, local health care providers indicated the increasing likelihood of an annual COVID booster.
Fries said we will get to an annual vaccination for COVID, adding, “It’s the same as we see with the flu.”
In general, people aren’t rushing off to get an updated COVID booster.
“To maximize the protective value of the vaccine while minimizing the number of vaccines you use, people should likely get the vaccine two weeks before they anticipate heavy exposure,” Clouston said.
For most people, that would mean getting the shot in early November to prepare for larger indoor gatherings, like Thanksgiving and the December holidays.
In a recent article in the journal Lancet, researchers conducted an extensive analysis of COVID reinfection rates.
The study dealt only with those people who had not had any vaccinations and addressed the effectiveness of natural immunity from preventing infections and from the worst symptoms of the disease.
Prior infections in general didn’t prevent people from getting reinfected, but it does “protect you from getting a really bad disease and dying,” Fries said.
Long COVID
Even with the number of people contracting COVID declining, the overall population of people battling symptoms of long COVID, which can still include anything from loss of smell and taste to chronic fatigue, continues to increase.
“There’s a plethora of symptoms of long COVID,” Fries said. “We’ll have to figure out how to classify this and hopefully come up with better therapy. Right now, we can only symptomatically treat these patients.”
Dr. Sritha Rajupet, director of the Stony Brook Medicine Post-COVID Clinic, explained in an email that some patients who have lost their sense of smell or have a distorted sense of taste have tried a process called a stellate ganglion block “after several case reports and early research have shown that it could be helpful.”
In such a procedure, doctors inject a local anesthetic on either side of the voice box into the neck. Rajupet said that “additional research and clinical trials still have to be performed.”
Newborns and COVID
As for children infected with COVID soon after birth, doctors suggested that the impact has been manageable.
“The great majority of young children who contract COVID do quite well and recover fully,” Dr. Susan Walker, pediatrician with Stony Brook Children’s Services, explained in an email. “The impact on their development from having actually experienced COVID illness is minimal.”
Children hospitalized with more significant illness from COVID might experience temporary developmental regression which is common in children hospitalized for any reason. The developmental impact seems more tied to social isolation.
“Children born during the pandemic spent their first years of life rarely seeing adults or children other than those in their immediate family,” Walker said. “The result is that many of these kids became excessively stranger anxious and timid around others.”
The lost social opportunities, the pediatrician said, resulted in delays in the personal/social domain of development. She added, “The good news is that kids are resilient and, in time, with appropriate social stimulation, [these children] should be able to regroup and catch up developmentally.”
Gurwin Jewish Nursing & Rehabilitation Center in Commack has announced that Janet Osita, RRT, Respiratory Therapist on Gurwin’s Respiratory Care unit, captured the award for Best Overall testimonial video in the LeadingAge NY and Adult Day Health Care Council (ADHCC) #LoveThisCareerLTC Social Media Contest.The inaugural social campaign was launched in an effort to raise the profile of rewarding opportunities within the long-term care sector.
“We are delighted that the video highlighting Janet’s hard work and her passion for her career and the residents for whom she cares was recognized with this award.Long-term care providers need skilled and compassionate workers like Janet who are dedicated to the well-being of our residents,” said Stuart B. Almer, President and CEO of Gurwin Healthcare System.
The contest encouraged LeadingAge NY and ADHCC member organization employees across all departments and services lines to create and post video content via TikTok, Instagram and/or Facebook to inspire others to pursue a meaningful career in long-term care and aging services. Contest prizes up to $1,000 were awarded to the creators of the best videos in the categories of Best Overall, Most Heartwarming, Most Creative/Best Use of Popular Social Media Trends and more.
“I love working in long-term care because of the passion, love and connection. When you work in a hospital, we see the patient, we treat them, then they go. With long-term care, you connect with them, and you have the passion. You know everything about them,” said Osita.
Dr. Bettina Fries. Photo by Jeanne Neville/Stony Brook Medicine
Bettina Fries, MD, Chief of the Division of Infectious Diseases, Professor of Medicine, and Molecular Genetics and Microbiology in the Renaissance School of Medicine at Stony Brook University, has been named a 2022 fellow of the American Association for the Advancement of Science (AAAS).
The AAAS is dedicated to elevating the quality of science and technology across the world for the benefit of humankind, and its fellows represent members of the association who have made exceptional contributions to that mission.
Dr. Fries is a nationally recognized physician-scientist who specializes in mycology and also conducts research of antibodies in relation tovaccine development. Under her leadership, the Division of Infectious Diseases at Stony Brook has greatly expanded and rose to combat the COVID-19 Pandemic and lead clinical care and research throughout the pandemic and its changing circumstances.
From expanding clinical and basic research and improving patient care to allocating essential resources and protecting health care providers, Dr. Fries’ work in healthcare and infectious disease researchhas impacted both Stony Brook and other institutions.
In addition to her appointment as an AAAS fellow, the East Setauket resident is also a fellow of the Academy of Microbiology of America, a fellow of the Infectious Disease Society, and a fellow of the American College of Physicians. She has served as President of the Medical Mycological Society of the Americas, and the Infectious Diseases Society of New York.
Dr Fries’ work spans a wide range of disciplines, but her research chiefly investigates the pathogenesis of chronic fungal infections and the development of monoclonal antibodies against multidrug-resistant bacteria.
Editor’s Note: Dr. Bettina Fries was one of TBR News Media’s 2022 People of the Year.
Aquatic exercise can improve balance, strength and mobility. METRO photo
Simple exercises can help
By David Dunaief, M.D.
Dr. David Dunaief
We have had far more ice this winter than snow. Of particular concern is black ice, when a thin ice coating looks innocuously like a simple damp surface. This phenomenon has increased our risk for falling and injuring ourselves. I’ve received quite a few calls this winter from friends and patients who have taken tumbles resulting in broken bones and torn ligaments.
Even without icy steps and walkways, falls can be serious for older patients, where the consequences can be devastating. They can include brain injuries, hip fractures, a decrease in functional ability and a decline in physical and social activities (1). Ultimately, a fall can lead to loss of independence (2).
What increases fall risk?
There are many factors. A personal history of falling in the recent past is the most prevalent. However, there are other significant factors, such as age and medication use. Some medications, like antihypertensive medications, which are used to treat high blood pressure, and psychotropic medications, which are used to treat anxiety, depression and insomnia, are of particular concern. Chronic diseases can also contribute.Circumstances that predispose us to falls also involve weakness in upper and lower body strength, decreased vision, hearing disorders and psychological issues, such as anxiety and depression (3).
Simple ways to reduce fall risk
It is most important to exercise. We mean exercises involving balance, strength, movement, flexibility and endurance, all of which play significant roles in fall prevention (4). The good news is that many of these can be done inside with no equipment or with items found around the home. We will look more closely at the research.
Nonslip shoes are crucial indoors, and footwear that prevents sliding on winter ice, such as slip-on ice cleats that fit over your shoes, is a must. In the home, inexpensive changes, like securing area rugs, removing other tripping hazards, and adding motion-activated nightlights can also make a big difference.
Does your medication put you at risk?
There are several medications that heighten fall risk. Psychotropic drugs top the list, but what other drugs might have an impact?
A well-designed study showed an increase in fall risk in those who were taking high blood pressure medication (5). Those on moderate doses of blood pressure medication had the greatest risk of serious injuries from falls, a 40 percent increase.
These medications can reduce significantly the risks of cardiovascular disease and events, so physicians need to consider the risk-benefit ratio in older patients before stopping a medication. We also should consider whether lifestyle modifications, which play a significant role in treating this disease, can be substituted for medication (6).
The value of exercise
A meta-analysis showed that exercise significantly reduced the risk of a fall (7). It led to a 37 percent reduction in falls that resulted in injury and a 30 percent reduction in falls requiring medical attention. Even more impressive was a 61 percent reduction in fracture risk.
Remember, the lower the fracture risk, the more likely you are to remain physically independent. The author summarized that exercise not only helps to prevent falls but also fall injuries.
Unfortunately, those who have fallen before, even without injury, often develop a fear that causes them to limit their activities. This leads to a dangerous cycle of reduced balance and increased gait disorders, ultimately resulting in an increased fall risk (8).
What types of exercise are best?
Any consistent exercise program that improves balance, flexibility, and muscle tone and includes core strengthening can help improve your balance. Among those that have been studied, tai chi, yoga and aquatic exercise have all been shown to have benefits in preventing falls and injuries from falls.
A randomized controlled trial showed that those who did an aquatic exercise program had a significant improvement in the risk of falls (9). The aim of the aquatic exercise was to improve balance, strength and mobility. Results showed a reduction in the overall number of falls and a 44 percent decline in the number of exercising patients who fell during the six-month trial, with no change in the control group.
If you don’t have a pool available, tai chi, which requires no equipment, was also shown to reduce both fall risk and fear of falling in older adults (10).
Another pilot study used modified chair yoga classes with a small assisted living population (11). Participants were those over 65 who had experienced a recent fall and had a resulting fear of falling. While the intention was to assess exercise safety, researchers found that participants had less reliance on assistive devices and three of the 16 participants were able to eliminate their use of mobility assistance devices.
Our best line of defense against fall risk is prevention with exercise and reducing slipping opportunities. Should you stop medications? Not necessarily. If you are 65 and older, or if you have arthritis and are at least 45 years old, it may mean reviewing your medication list with your doctor. Before you consider changing your blood pressure medications, review your risk-to-benefit ratio with your physician.
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.
Obesity can reduce the benefits of supplementation
By David Dunaief, M.D.
Dr. David Dunaief
Here in the Northeast, it’s the time of year when colder temperatures mean we’re spending lots of time indoors. When we are outside, we cover most of our skin to protect us from the cold. This means we’re not getting a lot of sun. While this will make your dermatologist happy, it also means you’re probably not converting that sun exposure to vitamin D3.
There is no question that, if you have low levels of vitamin D, replacing it is important. Previous studies have shown that it may be effective in a wide swath of chronic diseases, both in prevention and as part of a treatment regimen. However, many questions remain.
Many of us receive food-sourced vitamin D from fortified packaged foods, where vitamin D has been added. This is because sun exposure — even under the best of circumstances — will not address all of our vitamin D needs. For example, in a study of Hawaiians, a subset of the study population who had more than 20 hours of sun exposure without sunscreen per week, some participants still had low vitamin D3 values (1).
We know vitamin D’s importance for bone health, but we have mixed data for other diseases, such as cardiovascular, autoimmune and skin diseases and cancer.
There is no consensus on the ideal blood level for vitamin D. For adults, the Institute of Medicine recommends between 20 and 50 ng/ml, and The Endocrine Society recommends at least 30 ng/ml.
Are there cardiovascular benefits to vitamin D?
Several observational studies have shown benefits of vitamin D supplements with cardiovascular disease. The Framingham Offspring Study showed that those patients with deficient levels were at increased risk of cardiovascular disease (3).
However, a small randomized controlled trial (RCT) called the cardioprotective effects of vitamin D into question (4). This study of postmenopausal women, using biomarkers such as endothelial function, inflammation or vascular stiffness, showed no difference between vitamin D treatment and placebo. The authors concluded there is no reason to give vitamin D for prevention of cardiovascular disease.
The vitamin D dose given to the treatment group was 2,500 IUs. Some of the weaknesses of the study were a very short duration and small study size.
How does vitamin Daffect mortality?
In a meta-analysis of a group of eight studies, vitamin D with calcium reduced the mortality rate in the elderly, whereas vitamin D alone did not (5). The difference between the groups was statistically important, but clinically small: nine percent reduction with vitamin D plus calcium and seven percent with vitamin D alone.
One of the weaknesses of this analysis was that vitamin D in two of the studies was given in large amounts of 300,000 to 500,000 IUs once a year, rather than taken daily. This has different effects.
Does obesity affect vitamin D absorption?
A recently published analysis of data from the VITAL trial, a large-scale vitamin D and Omega-3 trial, found that those with BMIs of less than 25 kg/m2 had significant health benefits from supplementation versus placebo (2). These included 24 percent lower cancer incidence, 42 percent lower cancer mortality, and 22 percent lower incidence of autoimmune disease. Those with higher BMIs showed none of these benefits.
Can vitamin D help you lose weight?
There is good news, but not great news, on the weight front. It appears that vitamin D plays a role in reducing the amount of weight gain in women 65 years and older whose blood levels are more than 30 ng/ml, compared to those below this level, in the Study of Osteoporotic Fractures (6).
This association held true at baseline and after 4.5 years of observation. If the women dropped below 30 ng/ml in this time period, they were more likely to gain more weight, and they gained less if they kept levels above the target. There were 4,659 participants in the study. Unfortunately, vitamin D did not show statistical significance with weight loss.
USPSTF recommendations and fracture risk
The U.S. Preventive Services Task Force recommends against giving “healthy” postmenopausal women vitamin D, calcium or the combination of vitamin D 400 IUs plus calcium 1,000 mg to prevent fractures, and it found inadequate evidence of fracture prevention at higher levels (7). The supplement combination does not seem to reduce fractures, but does increase the risk of kidney stones. There is also not enough data to recommend for or against vitamin D with or without calcium for cancer prevention.
When should you supplement?
It is important to supplement to optimal levels, especially since most of us living in the Northeast have insufficient to deficient levels. While vitamin D may not be a cure-all, it might play an integral role with many disorders. But it is also important not to raise the levels too high. The range that I tell my patients is between 32 and 50 ng/ml, depending on their health circumstances.
References:
(1) J Endocrinology & Metabolism. 2007 Jun;92(6):2130-2135. (2) JAMA Netw Open. 2023 Published online Jan 2023. (3) Circulation. 2008 Jan 29;117(4):503-511. (4) PLoS One. 2012;7(5):e36617. (5) J Women’s Health (Larchmt). 2012 Jun 25. (6) J Clin Endocrinol Metabol. May 17, 2012 online. (7) JAMA. 2018;319(15):1592-1599.
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.
Each year, the Department of Health will release updated resource and income levels for theMedicaid program. This year there has been a significant increase. Beginning January 1, 2023,New York State will be increasing the asset limits for community and nursing home Medicaid and income limits for community Medicaid.
For both community (home health aides) and chronic (nursing home) Medicaid, the availableasset limit for 2023 is being increased to $28,133 for an individual applicant (the former assetlimit for 2022 was $16,800) and $37,902 for a married couple (up from $24,600), allowingMedicaid applicants to retain significantly more assets and still be eligible for Medicaid.
The income limit for community Medicaid applicants is being increased from $934/month to$1,563/month for individual applicants and for married couples the income limit is beingincreased from $1,367/month to $2,106/month. There is an additional $20.00 disregard thatcan be added to each allowance; therefore, the total of income allowance for an individualapplying for Medicaid can have $1,583/month and married couples can have $2,126.00.
Underthis program, any excess income can be directed to a Pooled Income Trust for the benefit ofthe Medicaid applicant and the monies deposited into the trust can be used to pay thehousehold expenses of the Medicaid applicant. In New York, all Pooled Income Trust aremanaged by charitable organizations. It is important to use the monies in the Pooled Income Trust because when the applicant passes away, the balance goes to the charity.
As for nursing home Medicaid applicants, the monthly income limit will continue to be $50, but the income limit for the non-institutionalized spouse is being increased to $3,715/month.Additionally, federal guidelines permit community spouses to retain up to $148,620 in assets plus a primary residence with a maximum value of $1,033,000.
Even if the communitysouse has assets and income over the threshold, New York’s spousal refusal provisions provide even more protection in that a community spouse can elect to sign a documentwhich allows them to retain assets in any amount, including assets which were previously in the name of the spouse that requires care in a nursing facility.
Individuals applying for Medicaid benefits after January 1, 2023, should apply based on theasset and income limits discussed above. For those individuals who are already receivingcommunity Medicaid and are using a pooled trust for their excess monthly income, yourmonthly budget/spend-down will remain the same until you recertify, at which time theincreased income limits will be applied.
However, starting in January 2023 Medicaidrecipients may ask their local Medicaid office to re-budget their spend-down based on thenew income limits before their next renewal, enabling community Medicaid recipients tokeep more of their monthly income sooner. It is advisable to consult an elder law attorneyin your area to determine if a re-budget is appropriate in your case.
While the asset allowance has been increased, keep in mind that the five-year look-backperiod for nursing home Medicaid still applies, which means that any transfer of assets madewithin this period for below market value will incur a penalty period and Medicaid coveragewill commence only after the penalty period has elapsed. Typically, there is alwaysMedicaid planning that can be accomplished even if the individual immediately needsMedicaid coverage and has done no pre-planning.
*Please note, the income and assets are based on the 2022 Poverty Level. This is subject tochange based on the 2023 Poverty Level.
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.
Exercise is only one part of the weight loss equation
By David Dunaief, M.D.
Dr. David Dunaief
Exercise has benefits for a wide range of medical conditions, from insomnia, fatigue, depression and cognitive decline to chronic kidney disease, diabetes, cardiovascular disease and osteoporosis. But will it help you lose weight?
While exercise equipment and gym membership ads emphasize this in January, exercise without dietary changes may not help many people lose weight, no matter what the intensity or the duration (1). If it does help, it may only modestly reduce fat mass and weight for the majority of people. However, it may be helpful with weight maintenance.
Ultimately, it may be more important to reconsider what you are eating than to succumb to the rationalization that you can eat with abandon and work it off later.
Does exercise help with weight loss?
The well-known weight-loss paradigm is that when more calories are burned than consumed, we will tip the scale in favor of weight loss. The greater the negative balance with exercise, the greater the loss. However, study results say otherwise. They show that in premenopausal women there was neither weight nor fat loss from exercise (2). This involved 81 women over a short duration, 12 weeks. All of the women were overweight to obese, although there was great variability in weight.
However, more than two-thirds of the women gained a mean of 1 kilogram, or 2.2 pounds, of fat mass by the end of the study. There were a few who gained 10 pounds of predominantly fat. A fair amount of variability was seen among the participants, ranging from significant weight loss to substantial weight gain. These women were told to exercise at the American College of Sports Medicine’s optimal level of intensity (3). This is to walk 30 minutes on a treadmill three times a week at 70 percent VO2max — maximum oxygen consumption during exercise. This is a moderately intense pace.
The good news is that the women were in better aerobic shape by the end of the study. Also, women who had lost weight at the four-week mark were more likely to continue to do so by the end of the study.
Other studies have shown modest weight loss. For instance, in a meta-analysis involving 14 randomized controlled trials, results showed that there was a disappointing amount of weight loss with exercise alone (4). In six months, patients lost a mean of 1.6 kilograms, or 3.5 pounds, and at 12 months, participants lost 1.7 kilograms, or about 3.75 pounds.
Does exercise help with weight maintenance?
Exercise may help with weight maintenance, according to observational studies. Premenopausal women who exercised at least 30 minutes a day were significantly less likely to regain lost weight (5). When exercise was added to diet, women were able to maintain 30 percent more weight loss than with diet alone after a year in a prospective study (6).
Does exercise help with disease?
As a simple example of exercise’s impact on disease, let’s look at chronic kidney disease (CKD), which affects approximately 15 percent of U.S. adults, according to the Centers for Disease Control and Prevention (7).
Trial results showed that walking regularly could reduce the risk of kidney replacement therapy and death in patients who have moderate to severe CKD, stages 3-5 (8). Yes, this includes stage 3, which most likely is asymptomatic. There was a 21 percent reduction in the risk of kidney replacement therapy and a 33 percent reduction in the risk of death when walkers were compared to non-walkers.
Walking had an impressive impact, and results were based on a dose-response curve. In other words, the more frequently patients walked during the week, the better the probability of preventing complications. Those who walked between one and two times per week had 17 and 19 percent reductions in death and kidney replacement therapy, respectively, while those who walked at least seven times per week saw 44 and 59 percent reductions in death and kidney replacement. These are substantial results. The authors concluded that the effectiveness of walking on CKD was independent of kidney function, age or other diseases.
As you can see, there are many benefits to exercise; however, food choices will have a greater impact on weight and body composition. The good news: exercise can help maintain weight loss and is extremely beneficial for preventing progression of chronic diseases, such as CKD.
By all means, exercise, but to lose weight, also focus on consuming nutrient-dense foods instead of calorie-dense foods that you may not be able to exercise away.
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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