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By Nancy Marr

Climate change is the most important threat we face, as one of the three greatest threats imperiling the Earth, in addition to the loss of biodiversity and global pollution. Reducing the carbon dioxide that we release into the atmosphere into the atmosphere is critical. The mantra — reduce, reuse, recycle — has become more important as incomes rise and consumption increases, particularly in urbanizing communities where local government must find ways to deal with the waste stream. 

Leftover food is a major component of landfill waste. It has been estimated that only 40% of the food that is produced is consumed, due partly to overproduction on farms and poor distribution methods. The EPA estimates that food waste comprises about 22% of our entire waste stream.

In 2022 the Food Donation and Food Scraps/Recycling Law will take effect in New York State. It will require businesses that generate an average of two tons of excess edible food per week to donate it to food banks and charities. All remaining food scraps, if the business is within 25 miles of an organics recycler, must be recycled instead of ending up in a landfill. 

One method is feeding it to an anaerobic digester, in which microorganisms break down organic materials in a closed space where there is no air (or oxygen). The material that is left over following the anaerobic digestion process, called digestate, can be made into soil amendments and fertilizers, improving soil characteristics and facilitating plant growth. 

Biogas, which is produced throughout the anaerobic digestion process, is a renewable energy source that can be used in a variety of ways, depending on its quality. Biogas treated to meet pipeline quality standards can be distributed through the natural gas pipeline and used in homes and businesses.  However, on the controversial side of this positive energy gain, remains the fact that anaerobic digesters generate an inordinate amount of methane (CH4), an enemy in our effort to combat climate change. 

Our waste stream includes packaging materials and paper goods. Bill S1185 has been introduced by Senator Todd Kaminski and it will be followed by A5801, to be introduced by Assemblyman Steve Englebright. They require producers and manufacturers to finance the recycling of their packaging materials and plastics, with incentives for finding ways of making recycling easier. Within three years of the bill’s implementation, producers will have to comply with the provisions of the bill or work with a producer responsibility organization. 

Very good news is that agronomists have found that improved soil management can reduce the carbon that is released into the atmosphere and can increase the amount of carbon that is drawn down into the soil through photosynthesis. Led by Suffolk County Cooperative Extension, many farmers are using the methods of no-till farming, cover crops, and natural fertilizers, recognizing the importance of the biodiversity of the soil. Farming can transition from a net carbon emitter to a carbon sink.

In order to reduce the amount of methane coming from landfills, New York State passed a law in 1990 that prohibited municipalities from retaining household waste in their landfills.  (Construction and yard waste and recyclables can remain.)  

In the case of Brookhaven Town, which built a landfill in 1974 in Yaphank, the waste is currently transported to a waste-to-energy facility in Hempstead for incineration. The ash by-product is then returned to Brookhaven (along with the ash from four other  municipalities) to be deposited in the Brookhaven landfill, which will be closed in 2024.  There is a question of how that ash will be stored, recycled, or disposed of. Until we can get to zero waste that question will remain. Can we do so in a timely way? Can we do so at all?

The League of Women Voters of New York State supports policies that protect food production and distribution while diverting food waste from landfills, incinerators and other waste treatment facilities. 

One thing we already know: we will only achieve zero waste conditions when everyone participates.   Look for ways to make easy changes at home – using imperfect fruits and vegetables and organizing your pantry can help reduce waste. Plan to re-use and repair your goods, recycle, and compost your food waste.  Regenerative farming methods will improve the soil in suburban gardens and lawns as well as farms.  Let your state legislators know that you support the EPR bill to require end-of-life recycling by producers.

Nancy Marr is vice-president of the League of Women Voters of Suffolk County, a nonprofit nonpartisan organization that encourages the informed and active participation of citizens in government and influences public policy through education and advocacy. Visit www.lwv-suffolkcounty.org or call 631-862-6860.

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If you sneeze and cough during certain times of the year, you may have seasonal allergies. Photo from Pixabay
Reducing inflammation may diminish symptoms
Dr. David Dunaief

By David Dunaief, M.D.

This weekend, after a week of warmer weather, we will adjust our clocks for Daylight Savings Time, the unofficial end of winter. We look forward to longer days, flowering gardens and “greening” trees. However, for people who suffer from seasonal allergic rhinitis, hay fever, seasonal allergies or whatever you would like to call it, life is about to get miserable.

Just over 19 million U.S. adults were diagnosed with seasonal allergies in 2018, and an additional 5.2 million children were diagnosed, according to the Centers for Disease Control and Prevention (1).

The triggers for seasonal allergies are diverse. They include pollen from leafy trees and shrubs, grass and flowering plants, as well as weeds, with the majority from ragweed (mostly in the fall) and fungus (summer and fall) (2).

What sparks allergic reactions? 

A chain reaction occurs in seasonal allergy sufferers. When foreign substances such as allergens (pollen, in this case) interact with immunoglobulin E (IgE), antibodies that are part of our immune system, they cause mast cells in the body’s tissues to degrade and release inflammatory mediators. These include histamines, leukotrienes and eosinophils in those who are susceptible. In other words, it is an allergic inflammatory response.

The revved up immune system then responds with sneezing; red, itchy and watery eyes; scratchy throat; congestion; sinus headaches; postnasal drip; runny nose; diminished taste and smell; and even coughing (3). Basically, it emulates a cold, but without the virus. If symptoms last more than 10 days and are recurrent, then it is more than likely you have allergies.

If allergic rhinitis is not properly treated, complications such as ear infections, sinusitis, irritated throat, insomnia, chronic fatigue, headaches and even asthma can result (4).

Medical treatment options 

The best way to treat allergy attacks is to prevent them, but this is can mean closing yourself out from the enjoyment of spring by literally closing the windows, using the air-conditioning, and using recycling vents in your car.

On the medication side, we have intranasal glucocorticoids (steroids), oral antihistamines, allergy shots, decongestants, antihistamine and decongestant eye drops, and leukotriene modifiers (second-line only).

The guidelines for treating seasonal allergic rhinitis with medications suggest that intranasal corticosteroids (steroids) should be used when quality of life is affected. If there is itchiness and sneezing, then second-generation oral antihistamines may be appropriate (5). Two well-known inhaled steroids that do not require a prescription are Nasacort (triamcinolone) and Flonase (fluticasone propionate). While inhaled steroids are probably most effective in treating and preventing symptoms, they need to be used every day and do have side effects.

Oral antihistamines, on the other hand, can be taken on an as-needed basis. Second-generation antihistamines, such as loratadine (Claritin), cetirizine (Zyrtec) and fexofenadine (Allegra), have less sleepiness as a side effect than first-generation antihistamines.

Alternative treatments 

Butterbur (Petasites hybridus), an herb, has several small studies that indicate its efficacy in treating hay fever. In one randomized controlled trial (RCT) involving 131 patients, results showed that butterbur was as effective as cetirizine (Zyrtec) in treating this disorder (6).

In another RCT, results showed that high doses of butterbur — 1 tablet given three times a day for two weeks — was significantly more effective than placebo (7). Researchers used butterbur Ze339 (carbon dioxide extract from the leaves of Petasites hybridus L., 8 mg petasines per tablet) in the trial.

A post-marketing follow-up study of 580 patients showed that, with butterbur Ze339, symptoms improved in 90 percent of patients with allergic rhinitis over a two-week period (8). Gastrointestinal upset occurred as the most common side effect in 3.8 percent of the population.

The caveats to the use of butterbur are several. First, the studies were short in duration. Second, the leaf extract used in these studies was free of pyrrolizidine alkaloids (PAs). This is very important, since PAs may not be safe. Third, the dose was well-measured, which may not be the case with over-the-counter extracts. Fourth, you need to ask about interactions with your prescription medications.

Dietary interventions 

While there are no significant studies on diet, there is one review of literature that suggests that a plant-based diet may reduce symptoms of allergies, specifically rhinoconjunctivitis, affecting the nose and eyes, as well as eczema and asthma. This is according to the International Study of Asthma and Allergies in Childhood study in 13- to 14-year-old teens (9). In my clinical practice, I have seen patients who suffer from seasonal allergies improve and even reverse the course of allergies over time with a vegetable-rich, plant-based diet, possibly due to its anti-inflammatory effect.

While allergies can be miserable, there are a significant number of over-the-counter and prescription options to help reduce symptoms. Diet may play a role in the disease process by reducing inflammation, though there are no formal studies. There does seem to be promise with some herbs, especially butterbur. However, alternative supplements and herbs lack large, randomized clinical trials with long durations. Always consult your doctor before starting any supplements, herbs or over-the-counter medications.

References:

(1) CDC.gov. (2) acaai.org/allergies/types/pollen-allergy. (3) J Allergy Clin Immunol. 2003 Dec;112(6):1021-31. (4) J Allergy Clin Immunol. 2010 Jan;125(1):16-29. (5) Otolaryngol Head Neck Surg. 2015 Feb;2:197-206. (6) BMJ 2002;324:144. (7) Arch Otolaryngol Head Neck Surg. 2004 Dec;130(12):1381-6. (8) Adv Ther. Mar-Apr 2006;23(2):373-84. (9) Eur Respir J. 2001;17(3):436-443.

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. 

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Aerobic exercise is good for the brain. METRO photo
Exercise may improve mild cognitive impairment

By David Dunaief, M.D.

Dr. David Dunaief

As we consider aging, many of us fear loss of our mental capability as much as loss of our physical capabilities. Yet, just as with physical capabilities, age is not the only determinant.

Mild cognitive impairment (MCI) is feared, not only for its own challenges but also because it may lead to dementia, with Alzheimer’s disease and vascular dementia being the more common forms. Prevalence of MCI may be as high as one-in-five in those over age 70 (1). It is thought that those with MCI may have a 10 percent chance of developing Alzheimer’s disease (2).

So, the most compelling questions are: What increases risk and what can we do to minimize the risk of developing cognitive impairment? Many chronic diseases and disorders contribute to MCI risk. These include diabetes, heart disease, Parkinson’s disease and strokes. If we can control these, we may reduce our risk of cognitive decline.

Heart disease creates substantial risk

In an observational study, results demonstrated that those suffering from years of heart disease are at a substantial risk of developing MCI (3). The study involved 1,450 participants who were between the ages of 70 and 89 and were not afflicted by cognitive decline at the beginning of the study. Patients with a history of cardiac disease had an almost two times greater risk of developing nonamnestic MCI, compared to those individuals without cardiac disease. Women with cardiac disease were affected even more, with a three times increased risk of cognitive impairment.

Nonamnestic MCI can affect executive functioning — decision-making abilities, spatial relations, problem-solving capabilities, judgments and language. It is a more subtle form of impairment that may be more frustrating because of its subtlety. It may lead to vascular dementia and may be a result of clots.

Strokes: where is more important than how many

Not surprisingly, stroke may have a role in cognitive impairment. Stroke is also referred to as a type of vascular brain injury. But what is surprising is that in a study, results showed that the location of the stroke was more relevant than the frequency or the multitude of strokes (4). If strokes occurred in the cortical and subcortical gray matter regions of the brain, executive functioning and memory were affected, respectively. Thus, the locations of strokes may be better predictors of subsequent cognitive decline than the number of strokes. Clinically silent strokes that were found incidentally by MRI scans had no direct effect on cognition, according to the authors.

Exercise benefits cognitive functioning

Exercise may play a significant role in preventing cognitive decline and possibly even improving MCI in patients who have the disorder. Interestingly, different types of exercise have different effects on the brain. Aerobic exercise may stimulate one type of neuronal development, while resistance training or weightlifting another.

In an animal study involving rats, researchers compared aerobic exercise to weightlifting (5). Weightlifting was simulated by attaching weights to the tails of rats while they climbed ladders. Both groups showed improvements in memory tests, however, there was an interesting divergence.

With aerobic exercise, the level of the protein BDNF (brain-derived neurotrophic factor) increased significantly. This is important, because BDNF is involved in neurons and the connections among them, called synapses, related mostly to the hippocampus, or memory center. The rats that “lifted weights” had an increase in another protein, IGF (insulin growth factor), that promotes the development of neurons in a different area of the brain. The authors stressed the most important thing is to exercise, regardless of the type.

In another study that complements the previous study, women were found to have improved spatial memory when they exercised — either aerobic or weightlifting (6). Interestingly, verbal memory was improved more by aerobic exercise than by weightlifting. Spatial memory is the ability to recall where items were arranged, and verbal memory is the ability to recall words. The authors suggest that aerobic exercise and weightlifting affect different parts of the brain.

This was a randomized controlled trial that was six months in duration and involved women, ages 70 to 80, who had MCI at the trial’s start. There were three groups in the study: aerobic, weightlifting and stretching and toning. Those who did stretches or toning alone experienced deterioration in memory skills over the same period.

A Centers for Disease Control and Prevention report claims the majority of the adult population is woefully deficient in exercise: Only about 1 in 5 Americans exercise regularly, both using weights and doing aerobic exercise (7).

Diet makes a difference

Several studies show that the Mediterranean diet helps prevent MCI and possibly prevents conversion from MCI to Alzheimer’s (8, 9). In addition, a study showed that high levels of carbohydrates and sugars, when compared to lower levels, increased the risk of cognitive decline by more than three times (5). The authors surmise that carbohydrates have a negative impact on insulin and glucose utilization in the brain.

Cognitive decline should be taken very seriously, and everything that can be done to prevent it should be utilized. Exercise has potentially positive effects on neuron growth and development, and controlling carbohydrate and sugar intake may reduce risk. Of course, if you have cardiovascular disease, making lifestyle changes to reverse or minimize its impact will reap both physical and cognitive rewards. Let’s not squander the opportunity to reduce the risk of MCI, a potentially life-altering disorder.

References:

(1) Ann Intern Med. 2008;148:427-434. (2) uptodate.com. (3) JAMA Neurol. 2013;70:374-382. (4) JAMA Neurol. 2013;70:488-495. (5) J Alzheimers Dis. 2012;32:329-339. (6) J Aging Res. 2013;2013:861893. (7) Morb Mortal Wkly Rep. 2013;62:326-330. (8) Neurology 2013;80:1684-1692. (9) Arch Neurol. 2009 Feb.;66:216-225.

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. 

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Adrian Popp, chair of Infection Control at Huntington Hospital/ Northwell Health and associate professor of Medicine at Hofstra School of Medicine, spoke with TBR News Media newspapers to discuss vaccinations and COVID-19. Please find below an abridged and edited version of the discussion.

TBR: Why do some people have a stronger reaction to a second shot?

POPP: These two vaccines are very well tolerated. Yes, there are some side effects after getting the shots. Indeed, even in the trials, it has been shown that the second shot is sometimes more prone to have side effects. There is pain, tenderness at the site of the shot. Sometimes people can get fatigue, fever and even a chill. It is rare to have something more severe than that … From my experience, most people tolerate them well, including the second shot.

TBR: Should people try to take at least a day off, if they can, after the second shot?

POPP: That is not necessarily unreasonable. A lot of my colleagues did take the shot later in the afternoon and then go home and rest for the evening. If you can afford to have a day off the next day, that’s probably not unreasonable.

TBR: Does having the vaccine free people up to interact with others?

POPP: What we know from the Moderna and Pfizer trials is that the effectiveness of the vaccination is 95 percent to prevent symptomatic disease … Can a vaccinated person develop a light form [of the disease]? In theory, yes. There are not completely safe in [not] transmitting the disease to someone else.

TBR: Have the Black and brown communities, which have been somewhat resistant to taking the vaccine, been included in the clinical studies?

POPP: Those studies with Pfizer and Moderna included these populations. They are well represented in these studies. There’s no significant difference in the side effects in African Americans, or less efficacy in the Black and brown communities …. [The Black and brown communities] should feel comfortable that it’s as safe or as efficacious as it is in a Caucasian person.

TBR: Have people from the Huntington Hospital or Northwell community asked you about the safety of taking the vaccine?

POPP: I do have conversations like this every day with different members of Huntington Hospital [as well as] the community at large … I bring up one very recent study that will probably help in kind of showing a few things. I’m going to bring in Israel, a smaller country with a centralized health care system that has been very good in vaccinating people …. More than 50 percent of their population has received the COVID vaccination. Specifically, the senior population, 65 and above, has received the vaccine in percentages even higher … In a study in the New England Journal of Medicine of more than 600,000 people who received the vaccine, [they] compared the incidence of COVID without the vaccine. They found the protection is more than 90 percent … That tells us the vaccine is very effective.

TBR: What do you hear about the Johnson & Johnson vaccine?

POPP: The best thing about the [J&J] vaccine is that it’s only one shot and the second thing is that it can be stored at normal temperature compared to the other vaccinations [which require deep freezing] … That allows it to be distributed more easily … It will probably be a good vaccine as well.

TBR: After the shots, what is the immunity?

POPP: After the first shot, approximately a week or two weeks after the first shot, you develop quite a significant level of antibodies. There is a certain amount of protection. With the second shot, the level of antibodies shoots up probably 10 times higher than after the initial shot … Full immunity is one week after you receive the second shot.

TBR: Some reports suggest that people who have COVID and develop antibodies may only need one shot. Is that true?

POPP: There are infectious disease experts looking into this. We do know that after getting COVID, you do develop a certain level of antibodies … That varies widely from person to person … The jury is still out on this one. Truly, we have to look at it in a more scientific way. We’ll find out if this will be an option down the road. At this point, as the recommendation stands, you do have to get both shots, even if you had COVID disease before.

TBR: Do we know more about why one person gets very sick and another has only mild symptoms?

POPP: Up to 50 percent of people who get COVID are either asymptomatic or have really minor symptoms. There are risk factors for developing a serious disease. We know that obesity, hypertension, diabetes and specifically certain immunocompromised conditions are risk factors for more serious disease. I have seen older people in their 90s who do have a mild form of the disease, then I’ve seen somebody in his 40s who has very severe disease … There is no real good way of saying who will develop a more severe disease versus somebody else who will have a milder form.

TBR: What about the aftereffects of COVID?

POPP: I have seen quite a few cases of people who … develop quite severe symptoms. On the milder end, people have a loss of taste and smell. This can last for some time … From my experience, most people will recover from this. On the other hand, people with more severe illness, people who get hospitalized, I have to say that the virus can take a significant toll on that person. I have seen patients who have lost 20 to 40 pounds over a period of a month or a month and a half … Recovering from such a hit of being sick for such a prolonged period of time takes a toll on people. Some patients also develop some degree of cognitive impairment.

TBR: What keeps you up at night?

POPP: Even though [the infection rate] is coming down in New York, it is still not insignificant. It’s still an issue. Until we get … a significant number of our population vaccinated, we’re still going to be in trouble … The only way we can stop the whole thing is by vaccinating as many people as we can.

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By Elissa Gargone

Elissa Gargone

If there’s one thing we’ve gained during this prolonged period of sheltering in place and social distancing otherwise known as the pandemic, it’s a deep appreciation for human interactions. Whether brief and in person as you say hello to your letter carrier, or digitally through a Zoom call with family or friends, these contacts make us feel good. They perk us up, stimulate our hearts and our brains and can brighten almost any day.  

Human beings are social creatures.  From the beginning of time, our connection to others has enabled us to survive and flourish. Spending too much time alone can leave us vulnerable to social isolation and loneliness, not to mention related health problems such as cognitive decline, depression, and heart disease. Fortunately, even at this time, there are ways to counteract these negative effects.

During the warmer weather, few of us hesitated to get outside for socially distanced get-togethers or walks, but winter’s chill presents another challenge.  While we can still bundle up for a walk or chat outside, most of us are more confined overall. Even so, getting out occasionally to be in the semi-distanced company of strangers can be invigorating.

Fortunately, our experience during COVID-19 has taught us some valuable lessons by further opening our minds to the great world at our fingertips through our keyboard, key pad and remote control device. At Jefferson’s Ferry Life Plan Community, we’ve strengthened our friendships and our resolve to stay in touch with the people in our lives, even if we have to step outside of our comfort zones.

While some people had an initial resistance to the digital world, most have come to eagerly embrace it and become adept and enthusiastic users. We’ve also adapted to using a number of the limitless apps available, from Zoom meetings to ordering take out, and from downloading podcasts to accessing art performances and information. We even have our own Jefferson’s Ferry app for the added convenience of fitness classes, entertainment, food and more from our devices.

Wherever you reside, social and digital media can introduce us to a whole new world of teachers, friends and entertainers. For many, Zoom, YouTube, FaceTime and TikTok have been a lifeline, keeping us connected with family, friends and even next door neighbors by providing laughs, new ideas, visits to nearby and faraway places and endless how-to videos. 

For the uninitiated, Zoom and FaceTime allow people to connect in real time video to socialize, hold meetings, go on a video excursion, and take classes. If you haven’t seen a loved one in a long time, FaceTime and Zoom are akin to a miracle. YouTube offers a vast compendium of content from performances to cooking and fitness classes of every description, and so much more. 

Your local library is a remarkable resource to entertain, educate and elevate emotional well-being. You can connect with fellow readers, travelers and lifelong learners through Zoom meetings and access an endless array of programming.   A phone call to the library or a visit to its YouTube channel can help you get online and get going to enjoy hours of fabulous programs and opportunities. 

Visit www.livebrary.com to access eBooks and Audiobooks (all you need is a Suffolk County library card) and go to your library’s website to explore its many offerings from the comfort of your home or bundle up and get out to experience nature, history and your overall environment in person on a beautiful winter afternoon. 

Either way you’ll experience a no or low-contact adventure in your own backyard. While we may be living through a time of more “at home time,” a whole world awaits at our fingertips. Make sure you take advantage of it. 

“Adventure isn’t hanging off a rope on the side of a mountain. Adventure is an attitude we must apply to the day to day obstacles of life.” — John Amat

Elissa Gargone is vice president of sales and marketing  at Jefferson’s Ferry Life Plan Community in South Setauket.

This article first appeared in TBR News Media’s Prime Times supplement on Jan. 28, 2021.

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Carol Gomes. Photo from SBU

In the face of an unprecedented COVID-19 pandemic, the Stony Brook Council has honored and bestowed University Medals for Exemplary Leadership and Service to three members of its Stony Brook University leadership. The Stony Brook Council serves as an oversight and advisory body to the campus and to Stony Brook’s president and senior officers.

These individuals were recognized for their extraordinary service in their areas of oversight, expertise and responsibility in protecting and caring for the Stony Brook community in the hospital system and on the Stony Brook University campuses. Their innovations, contributions and immediate responses to the pandemic were celebrated at a recent Stony Brook Council meeting. The individuals include:

“Our University community has benefited greatly from these individuals who inspire greatness in others, motivate teams to tackle the almost impossible and always place the greater good in front of mind,” said Kevin Law, President of the Stony Brook Council and President and CEO of the Long Island Association.  “We are grateful for their outstanding leadership and public service and recognize their exceptional achievements on behalf of Stony Brook University; Stony Brook Medicine; and our patients, students, faculty and staff.”

Carol Gomes

Carol A. Gomes was recognized for her administrative leadership for the following Stony Brook University Hospital achievements:

  • Development of surge plans to increase hospital capacity;

  • Helped establish a fully staffed field Emergency Room to manage surge in patient volume;

  • Creation of Oxygen Tank Farms prior to height of pandemic;

  • Creative solutions for the provision of Personal Protective Equipment to ensure staff safety;

  • Reprocessing of N95 respirators with Battelle Laboratories;

  • Successful collaboration with Stony Brook University for the manufacture of hand sanitizer, ventilators and 3-D face shields;

  •  Implementation of the “My Story” information boards about patients who were often unable to communicate because of their illness;

  •  Creation of a Respite Lounge to address the mental health needs of staff members and help deal with stress;

  •  Collaboration with SUNY Upstate Medical University to provide additional nursing staff during the height of the pandemic; and

  • Recognizing her steady, can-do spirit that helped the hospital serve as the backbone of the overall response to COVID-19 across Suffolk County.

Dr. Margaret McGovern

Dr. Margaret M. McGovern was recognized for her administrative leadership for the following Stony Brook Medicine achievements:

  • Oversight, focused dedication and expert leadership of Stony Brook Medicine’s staff and faculty during the COVID-19 pandemic that demonstrated incredible heroism, innovation, creativity and teamwork;

  • Stony Brook Medicine healthcare system collaborated successfully to manage patients at its four hospitals and across the entire continuum of ambulatory care settings, to make sure COVID-19 patients received the appropriate level of care;

  •  Expansion of telehealth services for outpatients, offered innovative technological solutions at patients’ bedsides to connect inpatients with loved ones during restricted visitation periods;

  • The establishment of a drive-through coronavirus testing site on Stony Brook University’s campus in conjunction with the New York State Department of Health to test thousands of Long Island residents for coronavirus;

  • The development of creative and innovative approaches to solve problems and support its staff, including new training programs and buddy programs, creation of the Respite Room, Team Lavender and the Hope Report;

  • Use of multi-disciplinary teams who were inspired to clear every obstacle to solve the problems that were presented each day allowed Stony Brook Medicine to form the backbone of the overall response to COVID-19 across Suffolk County; and

  • Leading the efforts to immunize staff and faculty and assist in vaccinating Long Island residents through public COVID-19 vaccinations sites.

Lawrence Zacarese

Lawrence M. Zacarese was recognized for his administrative leadership for the following Stony Brook University achievements:

  • Demonstrating compassion, dedication and extraordinary leadership that has been vital to Stony Brook University’s successful response to the COVID-19 pandemic;

  • Using his extensive experience and expert training in emergency management, he helped the campus community to face each challenge during this complex time with grace and keen determination;

  • Developing a comprehensive campus plan, creating a foundation of resiliency and commitment. As a result, Stony Brook was one of the few institutions in New York — and theonly SUNY University Center — to remain open as planned in the fall semester;

  •  Instituting the University’s Return to Research Plan that enabled Stony Brook to fast-track its researchers getting back in their labs, ensuring that the University’s mission to push the boundaries of science;

  •  Oversight of Stony Brook’s Return to Work and Return to Campus plans that provided a foundation for our work and our support for faculty, staff, students and the broader community, which was modeled by others in the SUNY System; and

  • Motivating teams to stay focused while tackling obstacles presented by the pandemic and being good regional partners through the management of COVID-19 public and university testing and vaccination sites.

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About Stony Brook University

Stony Brook University, widely regarded as a SUNY flagship, is going far beyond the expectations of today’s public universities. With more than 26,000 students, 2,700 faculty members, nearly 200,000 alumni, an academic medical center and 18 NCAA Division I athletic programs, it is one of only four University Center campuses in the State University of New York (SUNY) system. The University embraces its mission to provide comprehensive undergraduate, graduate, and professional education of the highest quality, and has been ranked among the top 35 public universities in the nation by U.S. News & World Report. Fostering a commitment to academic research and intellectual endeavors, Stony Brook’s membership in the Association of American Universities (AAU) places it among the top 65 research institutions in North America. The University’s distinguished faculty have earned esteemed awards such as the Nobel Prize, Pulitzer Prize, Indianapolis Prize for animal conservation, Abel Prize and the inaugural Breakthrough Prize in Mathematics. Part of the management team of Brookhaven National Laboratory of the U.S. Department of Energy, Stony Brook is one of only eight universities that has a role in running a national laboratory. Providing economic growth for neighboring communities and the wider geographic region, the University totals an impressive $7.23 billion in increased economic output on Long Island. Follow us on Facebook (https://www.facebook.com/stonybrooku/) and Twitter(@stonybrooku).

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 Stony Brook University Hospital

Stony Brook University Hospital (SBUH) is Long Island’s premier academic medical center. With 624 beds, SBUH serves as the region’s only tertiary care center and Regional Trauma Center, and is home to the Stony Brook University Heart Institute, Stony Brook University Cancer Center, Stony Brook Children’s Hospital and Stony Brook University Neurosciences Institute. SBUH also encompasses Suffolk County’s only Level 4 Regional Perinatal Center, state-designated AIDS Center, state-designated Comprehensive Psychiatric Emergency Program, state-designated Burn Center, the Christopher Pendergast ALS Center of Excellence, and Kidney Transplant Center. It is home of the nation’s first Pediatric Multiple Sclerosis Center. To learn more, visit www.stonybrookmedicine.edu/sbuh.

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Micronutrients are vitamins and minerals needed by the body in very small amounts. METRO photo
Micronutrient focus may reduce cravings

By David Dunaief, M.D.

Dr. David Dunaief

If we needed any more proof, this past year has been a good reminder that many things influence our eating behavior, including food addictions, boredom, lack of sleep and stress. This can make weight management or weight loss very difficult to achieve.

Unfortunately, awareness of a food’s caloric impact doesn’t always matter, either. Studies assessing the impact of nutrition labeling in restaurants gave us a clear view of this issue: knowing an item’s calories either doesn’t alter behavior or encourages higher calorie purchases (1, 2).

Does this mean we are doomed to acquiesce to temptation? Actually, no: It is not solely about willpower. Changing diet composition is more important.

How can we alter the dynamic? In my clinical experience, increasing the quality of food has a tremendous impact. Foods that are the most micronutrient dense, such as plant-based foods, rather than those that are solely focused on macronutrient density, such as protein, carbohydrates and fats, tend to be the most satisfying. In a week to a few months, one of the first things patients notice is a significant reduction in cravings. But don’t take my word for it. Let’s look at the evidence.

Examining refined carbohydrates

Many of us know that refined carbohydrates are not beneficial. Worse, however, a randomized control trial showed refined carbohydrates may cause food addiction (3). Certain sections of the brain involved in cravings and reward are affected by high-glycemic foods, as shown by MRI scans of trial subjects.

Study participants consumed a 500-calorie shake with either a high-glycemic index or a low-glycemic index. They were blinded (unaware) as to which they were drinking. The ones who drank the high-glycemic shake had higher levels of glucose in their blood initially, followed by a significant decline in glucose levels and increased hunger four hours later. The region of the brain that is related to addiction, the nucleus accumbens, showed a spike in activity with the high-glycemic intake.

According to the authors, this effect may occur regardless of the number of calories consumed. Granted, this was a very small study, but it was well designed. High-glycemic foods include carbohydrates, such as white flour, sugar and white potatoes. The conclusion: Everyone, but especially those trying to lose weight, should avoid refined carbohydrates. Calorie composition matters.

Comparing macronutrients

We tend to focus on macronutrients when looking at diets. These include protein, carbohydrates and fats, but are these the elements that have the greatest impact on weight loss? In an RCT, when comparing different macronutrient combinations, there was very little difference among groups, nor was there much success in helping obese patients reduce their weight (4, 5). Only 15 percent of patients achieved a 10 percent reduction in weight after two years.

The four different macronutrient diet combinations involved overall calorie restriction. In addition, each combination had either high protein, high fat; average protein, high fat; high protein, low fat; or low protein, low fat. Carbohydrates ranged from low to moderate (35 percent) in the first group to high (65 percent) in the last group. This was another well-designed study, involving 811 participants with an average BMI of 33 kg/m², which is classified as obese.

Again, focusing primarily on macronutrient levels and calorie counts did very little to improve results.

Adding micronutrients

In an epidemiological study looking at National Health and Nutrition Examination Survey data, results demonstrate that those who are overweight and obese tend to be lacking in micronutrients (6). These include carotenoids, such as lutein, zeaxanthin, beta-carotene, alpha-carotene and beta-cryptoxanthin, as well as vitamin B12, folate and vitamins C, E and D.

Unfortunately, taking supplements won’t solve the problem; supplements don’t compensate for missing micronutrients. Quite the contrary, micronutrients from supplements are not the same as those from foods. With a few exceptions, such as vitamin D and potentially B12, most micronutrient levels can be raised without supplementation, by adding variety to your diet. Please ask your doctor.

Lowering cortisol levels

The good news is that once people lose weight, they may be able to continue to keep the weight off. In a prospective (forward-looking) study, results show that once obese patients lose weight, the levels of cortisol metabolite excretion decrease significantly (7).

Why is this important? Cortisol is a glucocorticoid, which means it raises the level of glucose and is involved in mediating visceral or belly fat. This type of fat has been thought to coat internal organs, such as the liver, and result in nonalcoholic fatty liver disease. Decreasing the level of cortisol metabolite may also result in a lower propensity toward insulin resistance and may decrease the risk of cardiovascular mortality. This is an encouraging preliminary, yet small, study involving women.

Controlling or losing weight is not solely about willpower or calorie-counting. While calories have an impact, the nutrient density of the food may be more important. Thus, those foods high in a variety of micronutrients may also play a significant role in reducing cravings, ultimately helping to manage weight.

References:

(1) Am J Pub Health 2013 Sep 1;103(9):1604-1609. (2) Am J Prev Med.2011 Oct;41(4):434–438. (3) Am J Clin Nutr Online 2013;Jun 26. (4) N Engl J Med 2009 Feb 26;360:859. (5) N Engl J Med 2009 Feb 26;360:923. (6) Medscape General Medicine. 2006;8(4):59. (7) Clin Endocrinol.2013;78(5):700-705.

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. 

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Photo from Deposit Photos

Looking back on the response to the COVID-19 pandemic, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, expressed his frustration with the reaction to recommended safety measures.

“Public health issues got entangled in the profound divisiveness in our society,” Fauci said in a public discussion with the College of William & Mary president, Katherine Rowe, last week. “When you’re dealing with a common enemy, which is the virus, it is very counterproductive to be divisive over virtually everything you do.”

Fauci was frustrated that wearing a mask became a political statement, calling that “ridiculous” and suggesting that it “accounted for a less-than-optimal response that this country had.”

“I believe we’re going to get there within this calendar year.”

— Dr. Anthony Fauci

The disagreements were based “not on facts and science, but on political differences,” he said. In the next year, however, Fauci expressed hope that the country would have the virus under control and that it would eventually no longer threaten public health.

“I believe we’re going to get there within this calendar year,” Fauci said on the William & Mary call. “The problem is that a global pandemic requires a global response and if we don’t participate as [have] the other developed nations in the EU and in the U.K. and Canada and Australia, if we don’t participate in a program, in COVAX, that helps provide vaccines for the developing world … our problem will never go away.”

Indeed, last week, President Joe Biden (D) pledged $4 billion to the COVAX program at the G7 meeting.

Fauci pushed an initial estimate back for the time when vaccines for the virus would be available broadly to the United States population.

“One of the disappointments, which made me change [the] estimate, the Johnson & Johnson vaccine, which we anticipated would be coming in significant quantities in March and April, we learned that they will not have significant quantities until likely May and June,” Fauci said.

Reacting to a question from William & Mary Student Assembly president, Anthony Joseph, Fauci said, “Somebody like yourself, a young person, will likely have to wait until May.”

In response to a question about whether a vaccinated individual could be a carrier for COVID-19, Fauci said it is a “theoretical possibility — how likely that is, we do not know.”

The vaccination might prevent someone from showing clinical signs of the disease, but it might not keep someone from being a carrier.

He recommends people who have received the vaccine continue to wear a mask when they’re in the presence of people who have not been vaccinated, to prevent the possibility of infecting someone else.

New York State vaccinations

Snowstorms throughout the country this winter have disrupted the process of distributing vaccines.

New York State Department of Health said facilities where people scheduled appointments will connect with them before and during storms.

“As has been the case for past postponements, if any vaccine appointments at state-run sites are impacted by winter weather, they will be rescheduled over the following seven days,” a DOH spokesman said in a statement. “New Yorkers with appointments scheduled will receive an email or text message to reschedule their vaccination.”

Each resident who received a first dose at a state-run site will get a reminder email 24 hours before their second dose appointment.

When residents of the Empire State receive their first shot, they are required to schedule a second dose during that appointment.

Anyone who missed their appointment for a second shot should contact the call center to reschedule, if possible.

The state is required to keep a second dose on hand up to 42 days after a first shot, even though people who receive the Pfizer vaccine should get their second dose three weeks after the first shot and those who get the Moderna vaccine should return four weeks later. After 42 days, the state site can give the vaccine to someone else.

New York State requires all providers to keep a daily list of standby eligible people, in the event that an appointment opens up.

“As soon as providers are aware that there are more doses than people to be vaccinated, standby eligible individuals should be called, or other steps must be taken to bring additional eligible recipients to the facility or clinic before the acceptable use period expires,” the Health Department said in a statement.

Recognizing that the vaccination process can go awry during storms, providers can administer the vaccine to other public facing employees if extra doses remain at the end of a clinic and no one from a priority population can arrive before the doses expire.

As an example, the DOH suggested that commercial pharmacists who had already vaccinated eligible residents can offer the vaccine to members of the pharmacy department, store clerks, cashiers, stock workers and delivery staff.

“This exception is only for the purpose of ensuring vaccine is not wasted,” the spokesman said.

In remarks on Feb. 9, Gov. Andrew Cuomo (D) indicated that the supply of vaccines continues to lag well behind the demand.

“We now have about 10 million New Yorkers waiting on 300,000 doses,” Cuomo said. “The supply will only increase when and if Johnson & Johnson is approved. The Pfizer and Moderna vaccines are ramping up but the ramp-up is relatively slow, so we won’t see a major supply increase from Pfizer and Moderna, nowhere near what we would need to make rapid progress against the 10 million.”

Stony Brook vaccinations

Stony Brook University, meanwhile, announced that it reached a milestone last week when it distributed its 25,000th vaccine, exactly a month after the site started administering the vaccine. That means the university has vaccinated more than one person per minute for each of the 11 hours it’s been providing shots.

In a statement, President Maurie McInnis said she was “proud of the milestone” and called the effort by the university and Stony Brook Medicine “excellent work.”

SBU Hospital is also assisting in developing point-of-distribution sites in underserved communities on Long Island.

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Photo from BNL

COVID-19 needs no introduction. Scientists fighting it do.

John Hill leads the COVID-19 Science and Technology Working Group at the U.S. Department of Energy’s (DOE) Brookhaven National Laboratory. He also represents Brookhaven in a DOE consortium—the National Virtual Biotechnology Laboratory—which includes all 17 national laboratories working to address key challenges in responding to COVID-19.

The COVID-19 working group Hill leads at Brookhaven comprises experts in biology, nanoscience, computation, and other areas of science. They and their collaborators are leveraging world-class capabilities to study the structure of viral components, narrow the search for drugs, track research efforts, model the disease’s spread, and more.

Hill will give a virtual talk about the impacts of Brookhaven’s multifaceted COVID-19 research on Thursday, Feb. 25. The event, held from 6:30 to 7:30 p.m., will also include an interactive Q&A session, when audience members can submit questions for Hill and two of his colleagues:

How to join the event—and ask a question

This event will stream live on Twitter, Facebook, and YouTube. During the Q&A session, audience members can ask questions, using those streaming platforms’ chat functions.

You don’t need an account with Twitter, Facebook, or Google to watch the talk. You do need an account to ask questions via chat. Or you can email questions to [email protected] before the talk.

About the speakers

John Hill is the Deputy Associate Laboratory Director for Energy and Photon Sciences, and Director of the National Synchrotron Light Source II (NSLS-II), a DOE Office of Science User Facility at Brookhaven Lab. He previously served as leader for the X-ray Scattering group in the Lab’s Condensed Matter Physics and Materials Science Department. He is recognized as a world leader in x-ray scattering techniques for studying condensed matter systems.

Hill joined Brookhaven Lab as a postdoc in 1992, after earning a Ph.D. in physics from the Massachusetts Institute of Technology. He earned a bachelor’s degree in physics from Imperial College in London in 1986.

Kerstin Kleese van Dam is Director of the Computational Science Initiative (CSI) at Brookhaven Lab. CSI leverages computational science expertise and investments across multiple programs to tackle big-data challenges at the frontiers of scientific discovery. Kleese van Dam and collaborators at Brookhaven and Stony Brook University have applied simulations, machine learning, and other artificial intelligence tools in the fight against COVID-19.

Sean McSweeney is the Director of the Laboratory for BioMolecular Structure (LBMS) at Brookhaven. LBMS is home to state-of-the-art cryo-electron microscopes and other equipment for researchers to study the building blocks of all living organisms. Most of the data McSweeney and his group collected for COVID-19 research was done at NSLS-II.

Brookhaven National Laboratory is supported by the U.S. Department of Energy’s Office of Science. The Office of Science is the single largest supporter of basic research in the physical sciences in the United States and is working to address some of the most pressing challenges of our time. For more information, visit https://energy.gov/science.

Follow @BrookhavenLab on Twitter or find us on Facebook.

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From right, Dr. Maurie McInnis, President Of Stony Brook University, Wolfie and Dr. Margaret McGovern, Stony Brook Medicine Vice President for Health System Clinical Programs and Strategy, thank healthcare workers who are giving their time to help vaccinate Long Island.

Stony Brook University reached a major milestone in the COVID-19 vaccine distribution process on Thursday, February 18 when it administered the 25,000th vaccine at its state-run mass vaccination site. The site, established under the leadership of Governor Cuomo, opened on January 18. As the continued demand for COVID-19 vaccinations grows, Stony Brook University and Stony Brook Medicine have responded to the community’s need. Playing a critical role in carrying out New York State’s vaccination plans and contributing its R&D Park as an on-campus point of distribution (POD), staff went to work alongside the State to bring peace of mind to many people in an array of at-risk groups.

From left, Stony Brook University President Maurie McInnis, Stony Brook Medicine Vice President for Health System Clinical Programs and Strategy Dr. Margaret McGovern, 25,000 COVID-19 Vaccine recipient and Southampton resident Veronica Lang with her husband James, Wolfie, and Lisa Santeramo, assistant secretary for intergovernmental affairs.

“I am so proud of the milestone Stony Brook University, under Governor Cuomo’s leadership, has reached today in administering its 25,000th COVID-19 vaccine. This comes just one month after we opened the mass vaccination site at the University’s R&D Park on January 18. The efficient and effective administration of the vaccine is an example of the excellent work the University and Stony Brook Medicine have been doing to help stop the spread of COVID-19 and bring this pandemic to an end,” says President Maurie McInnis.

Widely regarded as a flagship campus for the State University of New York (SUNY) system, Stony BrookUniversity is bringing the full strength of its leadership, expertise, resources and quality care to further New York State’s goal of delivering life-saving vaccines to those who need it most.

The State also turned to Stony Brook University Hospital to assist in successfully developing community PODs as pop-up sites in underserved communities on Long Island, to reach communities of color and the elderly, as well as help build trust, recognizing that the vaccine is one of the best ways to protect ourselves, our families and our communities from this serious infectious disease.

Stony Brook Medicine Vice President for Health System Clinical Programs and Strategy Dr. Margaret McGovern adds, “Our success in administering vaccines at Stony Brook is a testament to our robust COVID-19 response activities, talent and expertise that are hallmarks of this University and premier academic medical center. It exemplifies how quickly and well we can coordinate our resources to best serve our community, on campus and off. We are continuing to administer as many doses of the COVID-19 vaccine as possible based on New York State eligibility requirements, distribution guidelines and vaccine supplies, and we will continue to lead all efforts we can to help ensure the health, safety and well-being of our local communities.”

To mark this occasion, Stony Brook University’s very own Wolfie joined public officials to show appreciation to all of the frontline workers manning the mass vaccination site.

Photos courtesy of Stony Brook University. 

VIDEO: Please see link to B-Roll here. Video courtesy of Stony Brook University. 

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