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It is very important to take white-coat hypertension seriously. Stock photo
As many as 30 percent of patients experience this phenomenon

By David Dunaief, M.D.

Dr. David Dunaief

White-coat hypertension (high blood pressure) is defined as blood pressure that is elevated to at least 140/90 mm Hg at a physician’s office, but “normal” when measured at home. The blood pressure considered normal at home for most Americans is less than 135/85 mm Hg. This is a real phenomenon caused by the anxiety or stress of being in a doctor’s office. It is also known as “isolated office hypertension.”

About 15 to 30 percent of patients experience white-coat hypertension (1). However, when the diastolic (bottom number) blood pressure is greater than 105 mm Hg, it is unlikely to be simply caused by doctor’s office-related stress (2).

Consequences

What are the consequences of white-coat hypertension? The first challenge is that physicians may overtreat it, prescribing medications that lead to low blood pressure when not in the office. Alternately, we sometimes discount it because it seems benign or harmless. However, some studies show that it may increase the risk of sustained hypertension, which is a major contributor to developing cardiovascular disease — heart disease and stroke.

It is very important to take white-coat hypertension seriously because Centers for Disease Control and Prevention data show that the percentage of adults age 20 and over with hypertension reached 33.5 percent in the 2013-14 period (3).

What can be done?

What can be done about white-coat hypertension? Well, it does not need to be treated with medication, except potentially in elderly patients (over 80 years of age) but should involve lifestyle modifications, including dietary changes, stress reduction and exercise. In terms of diet, increased beet juice, green leafy vegetables and potassium, as well as decreased sodium intake may be important. You should monitor the blood pressure at home, taking multiple readings during the day, or by 24-hour ambulatory blood pressure readings, which require wearing a monitor. The latter provides the additional advantage of blood pressure readings during your sleep.

If you do monitor your blood pressure at home, the American Heart Association has suggestions on how to get the most accurate readings, such as measurements early in the morning before exercising and eating, as well as in the evening (4). You should also be comfortably seated, don’t cross your legs, and sit/relax for a few minutes before taking a reading. Let’s look at the evidence.

Risk of sustained high blood pressure

There were no substantial studies demonstrating any consequences from white-coat hypertension until 2005. Most previous studies on white-coat hypertension were not of long enough duration.

In the 2005 population-based Ohasama study, results showed that the participants who had white-coat hypertension were 2.9 times more likely to develop sustained hypertension, compared to those who had normal blood pressure in the doctor’s office (5). There were almost 800 participants involved in this study, with a mean age at the start of 56. What was really impressive about the study was its duration, with an eight-year follow-up. This gives a better sense of whether white-coat hypertension may develop into sustained hypertension. The researchers concluded that it may lead to a less than stellar outlook for cardiovascular prognosis.

Another study, published in 2009, reinforced these results. The PAMELA study showed that those with white-coat hypertension had about a 2.5-times increased risk of developing sustained high blood pressure, compared to those who had normal readings in all environments (6). There were 1,412 participants involved in the study, ranging in age from 25 to 74. Just like the previous study, an impressive aspect was the fact that there was a long follow-up period of 10 years. Thus, this was a substantial study, applicable to the general population over a significant duration.

Prevention of sustained hypertension

In a small, randomized controlled trial, beet juice was shown to reduce blood pressure significantly (7). Patients either were given 250 ml (about 8 ounces) of beet juice or comparable amounts of water. The patients who drank the beet juice saw an 11.2 mm Hg decrease in blood pressure, while those who drank water saw a 0.7 mm Hg reduction. This effect with the beet juice continued to remain significant. Even after 24 hours, there was a sustainable 7.2 mm Hg drop in blood pressure, compared to readings taken prior to drinking the juice. Although these results are encouraging, we need to study whether these effects can be sustained over the long term. Also, this study was done in patients with high blood pressure. I don’t know of any prevention studies done in patients with white-coat hypertension.

The researchers believe the effect is caused by high nitrate levels in beet juice that are converted to nitrite when it comes in contact with human saliva. Nitrite helps to vasodilate, or enlarge blood vessels, and thus helps to decrease blood pressure in a similar way as some antihypertensive (blood pressure) medications. The authors go on to surmise that green leafy vegetables offer protection from cardiovascular disease in part due to increased nitrite levels, similar to those in beet juice. 

A subsequent double-blind, placebo-controlled clinical trial with 68 hypertensive patients found that blood pressure was significantly reduced in the clinic and in home readings over a four-week period, when compared to nitrate-free beet juice (8).

If you have diabetes, prediabetes, a family history or a high risk for diabetes, I recommend eating beets instead, since drinking beet juice will raise your sugar levels.

Increasing potassium levels significantly through food sources, not supplements, has a profound effect in reducing blood pressure. In a study where 3,500 to 4,700 mg of potassium were consumed through foods, the systolic (top number) blood pressure was reduced by 7.1 mm Hg (9). We should be getting 4,700 mg of potassium daily, which equates to about 10 bananas daily. Almonds, raisins and green leafy vegetables, such as Swiss chard, also have significant amounts of potassium.

White-coat hypertension should not be neglected. It is important to monitor blood pressure at home for at least three days with multiple readings, and then send them to your physician for review. Though patients don’t need to be on blood pressure medications at this stage, it does not mean you should be passive about the process. Make lifestyle modifications to reduce your risk of developing sustained hypertension.

References:

(1) Hypertension. 2013;62:982-987, originally published Nov 13, 2013. (2) J Hypertens. 2001;19(6):1015. (3) cdc.gov. (4) Am Fam Physician. 2005 Oct 1;72(7):1391-1398. (5) Arch Intern Med. 2005 Jul 11;165(13):1541-1546. (6) Hypertension. 2009; 54: 226-232. (7) Hypertension. Online 2013; April 15. (8) Hypertension. 2015 Feb; 65(2): 320–327. (9) BMJ. 2013 Apr 3;346:f1378. 

Dr. 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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Accumulating evidence supports an association between depression and inflammation. Stock photo
C-reactive protein is an important biomarker

By David Dunaief, M.D.

Dr. David Dunaief

Many of us have inflammation in our bodies, inflammation that is a potential underlying cause for a great number of diseases. Can we demonstrate the level of inflammation by measuring it? The answer is yes.

One of the most widely studied biomarkers for inflammation is high-sensitivity C-reactive protein (hsCRP), also referred to as CRP. High sensitivity means that we can measure levels as low as 0.3 mg/L more accurately.

What is the significance of the different levels? In heart disease, individuals who have levels lower than 1.0 mg/L are in the optimal range for low risk of inflammation. Levels of 1 to 3 mg/L represent the average risk range, and greater than 3.0 mg/L is a higher risk profile. Above 10.0 mg/L is less specific to heart disease, although still related, but more likely associated with other causes, such as infection and autoimmune diseases (1, 2). This biomarker is derived from the liver.

CRP is not specific to heart disease, nor is it definitive for risk of the disease. However, the upside is that it may be helpful with risk stratification, which helps us understand where we sit on a heart disease risk spectrum and with progression in other diseases, such as age-related macular degeneration, diabetic retinopathy, depression and autoimmune diseases. Let’s look at the evidence.

Age-related macular degeneration

Age-related macular degeneration (AMD) is the leading cause of blindness in patients over the age of 65 (3). Therefore, it is very important to help define risk stratification for this disease. In a prospective study, results showed that hsCRP levels were inversely associated with the risk of developing AMD. The group with an hsCRP greater than 3.0 mg/L had a 50 percent increased risk of developing overall AMD compared to the optimal group with hsCRP lower than 1.0 mg/L. But even more interestingly, the risk of developing neovascular, or wet, AMD increased to 89 percent in this high-risk group.

The significance of wet AMD is that it is one type of advanced-stage AMD that results in blindness. This study involved five studies where the researchers thawed baseline blood samples from middle-aged participants who had hsCRP levels measured. There were more than 2,000 participants with a follow-up as long as 20 years. According to the study’s authors, annual eye exams and lifestyle modifications, including supplements, may be able to stem this risk by reducing hsCRP.

These results reinforce those of a previous prospective study that showed that elevated hsCRP increased the risk of AMD threefold (4). This study utilized data from the Women’s Health Study, which involved over 27,000 participants. Like the study mentioned above, this one also defrosted blood samples from baseline and looked at follow-up incidence of developing AMD in initially healthy women.

The highest group had hsCRP levels over 5.2 mg/L. Additionally, when analyzing   similar cutoffs for high- and low-level hsCRP, as the above trial used, those with hsCRP over 3.0 had an 82 percent increased risk of AMD compared to those with an hsCRP of lower than 1.0 mg/L.

Diabetic retinopathy — a complication of diabetes

We know that diabetes affects approximately 10 percent of the U.S. population and is continuing to rise at a rapid rate. One of the complications of diabetes affects the retina (back of the eye) and is called diabetic retinopathy. This is a leading cause of vision loss (5). One of the reasons for the vision loss is macular edema, or swelling, usually due to rupture of tiny blood vessels below the macula, a portion of the back of the eye responsible for central vision.

The Diabetes Control and Complications Trial (DCCT), a prospective study involving over 1,400 Type 1 diabetes patients, showed an 83 percent increased risk of developing clinically significant macular edema in the group with the highest hsCRP levels compared to those with the lowest (6). Although these results were with Type 1 diabetes, patients with Type 2 diabetes are at equal risk of diabetic retinopathy if glucose levels, or sugars, are not well controlled.

Depression

Depression is a very difficult disease to control and is a tremendous cause of disability. If we can minimize the risk of complications and hospitalizations, this is probably the most effective approach.

Well, it turns out that inflammation is associated with depression. Specifically, in a prospective observational trial, rising levels of CRP had a linear relationship with increased risk of hospitalization due to psychological distress and depression (7).

In other words, compared to levels of less than 1 mg/L, those who were 1 to 3 mg/L, 3 to 10 mg/L and greater than 10 mg/L had increased risk from 30 to 84 to 127 percent, respectively. This study involved over 70,000 patients.

What can be done to reduce inflammation?

This is the key question, since we now know that hsCRP is associated with systemic inflammation. In the Nurses’ Health Study, a very large, prospective observational study, the Dietary Approaches to Stop Hypertension (DASH) diet decreased the risk of both heart disease and stroke, which is impressive. The DASH diet also decreases the levels of hsCRP significantly, which was associated with a decrease in clinically meaningful end  points of stroke and heart disease (8).

The DASH diet is nutrient dense with an emphasis on fruits, vegetables, nuts, seeds, legumes and whole grains and a de-emphasis on processed foods, red meats, sodium and sweet beverages.

Conclusion

As the evidence shows with multiple diseases, hsCRP is a very valuable nonspecific biomarker for inflammation in the body.

To stem the effects of inflammation, reducing hsCRP through lifestyle modifications and drug therapy may be a productive way of reducing risk, slowing progression and even potentially reversing some disease processes.

The DASH diet is a very powerful approach to achieving optimal levels of hsCRP without incurring potential side effects. This is a call to arms to have your levels measured, especially if you are at high risk or have chronic diseases such as heart disease, diabetes, depression and autoimmune diseases. HsCRP is a simple blood test with easy-to-obtain results.

References:

(1) uptodate.com. (2) Diabetes Technol Ther. 2006;8(1):28-36. (3) Prog Retin Eye Res. 2007 Nov;26(6):649-673. (4) Arch Ophthalmol. 2007;125(3):300-305. (5) Am J Ophthalmol. 2003;136(1):122-135. (6) JAMA Ophthalmol. 2013 Feb 7;131:1-8. (7) JAMA Psychiatry. 2013;70(2):176-184. (8) Arch Intern Med. 2008;168(7):713-720.

Dr. 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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It was five years since I had a colonoscopy, so I made an appointment to repeat the procedure. It was not a date on the calendar I was looking forward to. I understand the importance of this test for me, so I did what I had to do. My dad died of intestinal cancer, as did several of his siblings, so the family warning is clear. Had this test been available at the time he was stricken, and his cancer discovered, I have little doubt that my dad, a robust and athletic man, would have otherwise lived a longer life than his 70 years.

A 2015 German study published in the European Journal of Cancer confirmed that colonoscopy screening “will lead to substantial reductions in the colorectal cancer burden.”

So what is a colonoscopy? I write to explain the test in the hopes of encouraging any readers who might be postponing and avoiding that appointment to take care of that little task once they turn 50. It is my understanding that in most cases, health insurance will cover the costs, which in itself is evidence of the importance of the test. And the experience is not so awful. In fact there is, so to speak, a silver lining, but more about that later.

Here are the details. A flexible tube, called a colonoscope, with a video camera on the end that is connected to a large screen in the room, is inserted through the rectum and allows the gastroenterologist to examine the inside of the large intestine. The physician then searches for any abnormalities such as polyps, which can turn into cancer, and usually removes them. The scope rides on a cushion of air that is provided, kind of like a maglev train moves along smoothly without touching the ground through magnetic levitation. The actual procedure takes only about 30-45 minutes, but between the prep at the office and the recovery, it’s a two-to-four hour event.

The first time I had this test, I wanted to be awake to see the inside of the intestine, which is actually quite beautiful. It looks like a braid, as much more surface area can effectively fit into a small area. Tiny red and blue blood vessels crisscross the sides. Of course in order to see all this clearly, the intestine must first be totally cleaned out, which is probably the less pleasant part of the whole deal. Some fasting is involved, anything red, like a tomato, or a seed or nut that might block the view, is to be avoided, and in the last 12 hours before the test, a liquid laxative that spikes 64 ounces of Gatorade is ingested.

I was advised to wear loose and comfortable clothing and to leave cash and jewelry at home. Upon arrival, I was given two of those infamous hospital gowns, one to face front and the other the rear. My clothes were secured in a locker, and after a thorough history was unhurriedly taken, the nurse placed an intravenous (IV) line into my arm.

After my first experience, I chose to be fully sedated this time. I was given the good news, that all was well, when I awoke. As a result of the sedation, however, I could not just get up and drive but needed to be accompanied by a companion. In my case it was my son, who could steer me through the hallway and into the car, then drive me home. Shortly after I arrived back in the kitchen, I realized I was ravenous and began refilling my intestine.

There is a mild bit of bloating after the test as a result of the air that is added, but that is not particularly uncomfortable and disappears within hours. I was advised not to drive a car, operate any machinery or power tools (unlikely), drink any alcoholic beverages or make any important decisions until the following day.

There are other forms of the colonoscopy that are somewhat less invasive, but my understanding is that this variant is the most thorough and therefore the most desirable. As for the silver lining? I did appear to lose a couple of pounds, at least for now.

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Personal Fitness in Rocky Point. Photo from Facebook

By Kevin Redding

A Rocky Point fitness club owner is determined to get people in shape — inside the gym and beyond it.

Since 1989, North Shore residents have been going to Personal Fitness on Route 25A not just to run on the treadmill and get fit for beach season. They go to have their lives transformed by Ed Darcey, the gym’s owner, trainer and “overall cheerleader and therapist,” according to gym members, who are made up of athletes, parents, children, developmentally disabled residents, people in wheelchairs and those struggling with drugs, alcohol or abuse.

Ed Darcey, owner of Personal Fitness in Rocky Point, training a client. Photo from Facebook

“Ed is an inspirational, motivational, kind, empowering and passionate trainer,” said Faith Powers-Raynis, who joined the gym after suffering a spinal cord disease that paralyzed her from the waist down. “Ed is helping me to rebuild the muscles that I lost … I know with Ed’s help, I just might get back on my feet.”

“He’s a wonderful soul,” Lisa Monaco said. “He makes you feel comfortable and pushes you as far as you can go.”

Rob Geneva, a longtime customer turned staff member, said Darcey makes the atmosphere feel less like you’re in a gym and more like the bar from “Cheers.”

“Anybody is welcome and you just get that feeling right when you come in,” he said. “You’re not intimidated.”

Darcey, 54, a Shoreham native and Riverhead High School graduate, said he has always felt a need to help and protect those around him, whether it was a kid at school being bullied or a homeless person on the street asking for money. It’s a feeling that remains.

“If someone needs a hand, I’m going to try and reach out and do my best to help, especially those whose lives maybe aren’t what they should be,” Darcey said. “A lot of our members here see the gym as an outlet, like a second home. Sometimes they’re more comfortable here than they are at their actual home. They come here, get in shape and we all root each other on. I’m trying to help give them a better life if I can.”

A football player throughout high school, Darcey pursued a degree in physical education and health at C.W. Post, where he received his gym certification after three years. In his late 20s, he decided to take advantage of some empty space next door to his parent’s long-running carpet business on Route 25A, and he’s been there ever since.

“From the beginning, I tried to make it very personal and hands-on,” he said. “Lots of other gyms are these big franchises. This is a family-type atmosphere. We have members that have wheelchairs and walkers, and kids with cerebral palsy and Down syndrome. But in my gym, everybody’s the same. Some may have different limitations and abilities, but they’re all the same to me.”

The first time Rocky Point resident Rich Grundmann went to the gym, he saw a young woman with Down syndrome running on a treadmill and mentioned to a nearby trainer that his 12-year-old son Alex had cerebral palsy, wondering if he’d be able to get involved with the gym. The trainer encouraged the father to bring him by.

“After just one session there, my son just lit up,” Grundmann said. “And the personal attention they gave him was incredible. He’s been through all sorts of therapy, personal and occupational, but the trainers here really pushed him and he loves it. It’s amazing the amount of strength he’s built up since going there.”

Alex, he said, moves around in a walker and sometimes a wheelchair, and has a lot of spasticity. The trainers work on stretching his legs and arms to gain more mobility.

Ed Darcey, owner of Personal Fitness in Rocky Point. Photo from Facebook

“It gets frustrating for him at school because he looks around and he wants to do all the sports the other kids do and wants to feel like a regular teenager,” his father said. “But whenever he leaves the gym, he’s on cloud nine. There’s something about that place and Ed where everyone fits in. It’s like a big family.”

Amy Dias of Middle Island, who sustained a traumatic brain injury after a car accident on Middle Country Road in 2003, said Personal Fitness helped her feel confident again. Following the accident, which left her in a coma for nine months, doctors told Dias she would never speak or move again. A year after she joined the gym, she was walking with a cane and talking. She even lives on her own now.

“I’m not afraid to talk to people now and they definitely strengthened my right side, which got affected most,” Dias said. “I love everyone at the gym. Ed is wonderful and really helped me.”

And how did he do the impossible?

“He cares,” she said. “He honestly cares about every individual person.”

The gym owner also helps out in the local community, frequently lending a charitable hand to Ridge Full Gospel Christian Church, where he recently helped to feed and clothe the homeless on Thanksgiving. He raises funds and promotes any and all shelters and charity drives in the area, and is a regular contributor to Betty’s Closet, a store inside the Rocky Point Middle School cafeteria that helps raise money and collect toys and food for families in need.

“Whenever I post something about an upcoming event on my page, he’s always ready to help,” said Betty Loughran, the Rocky Point PTA member who created Betty’s Closet. “He gets all the gym members involved, donates gift cards and goods and whatever the community needs. He’s just a really good person. The gym is always open and if kids in the community are ever in trouble and need a place to go, he’s there for them.”

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United States Army Staff Sgt. Allen Pennington and Warrior Ranch Foundation Vice President Tony Simonetti spend time with Pennington’s horse Red. Photo from Warrior Ranch Foundation

When Marine Corps veteran StaceyAnn Castro first stepped into the round pen with a horse at Warrior Ranch Foundation, her guard was up.

Castro, who served in Operation Enduring Freedom from 2002 to 2004, and admittedly struggles with post-traumatic stress disorder, was face to face with a 1,400-pound Friesian horse named BlackJack during a July demonstration by the Mount Sinai and Islip-based nonprofit, which pairs military and first-responder veterans with rescue horses in need of rehabilitation and training.

Marine Corps veteran StaceyAnn Castro bonds with
Vet therapy: Mount Sinai’s Warrior Ranch helps heal
her horse BlackJack. Photo from Warrior Ranch
Foundation

The tough-as-nails veteran was attempting to engage BlackJack in basic ground exercises, but the horse was not budging. Its guard was up too.

“I soon realized it was because I was terrified of him,” Castro later said. “When you’re with these horses they feel everything you’re feeling, even the emotions you think you’re hiding from everybody else. You can’t hide them from a horse.”

Castro relaxed, and as she calmed down, so did BlackJack. The horse began to lick and chew — a reflex associated with the animal’s release of stress.

“By the end of the session, I wound up with a friend,” she said of BlackJack. “With the horses, you have someone you’re actually bonding with in your own private, silent language. It’s beautiful.”

Officially incorporated in June 2016, the Warrior Ranch Foundation has helped reduce the stress levels and PTSD symptoms of more than a dozen veterans still recuperating from a wide range of conflicts — from the Korean War to Vietnam War to the war in Afghanistan — by teaching them how to groom, feed and train troubled horses. And much like the veterans, the nine residential horses, mostly retired race and show animals that have been trained their whole lives to compete and perform in high-stakes settings, are learning to adapt to a new, more relaxed world.

Cathie Doherty spends time with horse Cody.
Photo from Warrior Ranch Foundation

“There’s a strong parallel between them and it’s amazing to see their emotional breakthroughs,” said Eileen Shanahan, the nonprofit’s founder and president. “While the race horses are trained to run, run, run, and as a result have emotional issues, the veterans are trained to go out there and do the best they can to protect and defend us. When they come back, they have to shut that off and that’s not so easy. We provide a safe haven for these humans and animals.”

Shanahan’s organization is the result of her lifelong love of country and horses. The Queens native, who shoots and produces television programs and commercials for a living, comes from a large military family with a father who served in the Marines, an uncle and brother in the Navy, nephews in the Army, as well as several first responders.

Although she mostly rode buses and subways growing up, Shanahan always admired horses from afar, seeing them as beautiful creatures.

When she got married and moved to East Quogue in the 1980s, she took up horseback riding and, 15 years ago, began adopting rescue horses and studying natural horsemanship — a variety of rapport-based horse training techniques.

United States Army Staff Sgt. Allen
Pennington with horse Red. Photo
from Warrior Ranch Foundation

For nearly a decade, she dreamt of providing this outlet for local veterans and finally launched it with the help of longtime friends and equestrians specialists. While the group currently works out of two private barns, the future plan is to turn Warrior Ranch into a national organization.

“We want to eventually help hundreds of veterans and horses because it really works,” Shanahan said, explaining that interactions like Castro’s is very common at the ranch. “A lot of times when they come here, the veterans have their arms crossed, but by the end of the day, they have ear-to-ear grins. A lot of them break down and cry and it’s so powerful to watch.”

Tony Simonetti, Warrior Ranch’s vice president and top horse trainer, has made a career of rehabilitating emotionally distraught horses and re-interacting them with their human counterparts, resolving more than 500 extremely difficult horse cases for people across the country. When asked his most memorable veteran-horse interaction within the organization, he talked about Army Staff Sergeant Allen Pennington, Warrior Ranch’s first soldier to go through the program, and Red, a 4-year-old, retired race thoroughbred.

“[Allen’s] this big, rough and tough guy, and when the horse connected with him, I just saw all the stress he was holding inside bubble right up through his chest and then he just couldn’t keep himself composed,” Simonetti said. “He broke down and turned around and hugged that horse like it was his battle buddy. And I told him, ‘don’t feel bad about that. That’s what you’re here for.’”

During a testimonial on the Warrior Ranch website, Navy veteran Cathie Doherty, who was diagnosed with PTSD and put on medication for a number of years, said she was grateful to have attended a women veteran’s retreat at the nonprofit.

United States Army Staff Sgt. Allen
Pennington with horse Red. Photo
from Warrior Ranch Foundation

“It was really an amazing experience,” Doherty said. “I think it touched me much deeper than I imagined it would. I appreciated working with the horses and that I had to make a connection with them. I feel I was present in the moment. I didn’t care about my phone, I didn’t care what was going on around me. It was a beautiful experience for me.”

Castro said companionship with a horse might be more beneficial than a human’s.

“When you’re a veteran and you’re having a bad day, you don’t want to tell anybody, you don’t want to talk about it — you want to forget about it,” she said. “But I also don’t want to be alone and, so, when you’re there with the horse, and that horse knows what you’re going through and feeling, he feels it too. And because you love the horse and you don’t want the horse to feel that way, you’re going to try and make yourself feel better. It’s awe-inspiring.”

U.S. Rep. Lee Zeldin (R-Shirley), who served four years in the Army, visited the ranch in Mount Sinai with his family Oct. 7 and saw firsthand the value of the nonprofit.

“It doesn’t take more than a few minutes to see the positive effects that you’re having on these horses, and from these horses the veterans are getting love that they possibly have never experienced
before,” Zeldin said. “In a way, you’re directly coping with the symptoms of PTSD while also productively escaping the worst of it. It’s a great concept and I’d love to see Warrior Ranch grow into something a whole lot bigger than it already is.”

U.S. Rep. Lee Zeldin, fifth from left, meets with members of the Warrior Ranch Foundation. Photo from Warrior Ranch Foundation

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Northport-East Northport school parent Mary Gilmore urged school officials to conduct a longitudinal study of air quality in the schools. Photo by Kevin Redding

The Northport-East Northport board of education called on a specialist last week in an attempt to clear the air with concerned parents over potential health risks from gas fumes detected at Northport Middle School last spring.

At the Sept. 28 meeting, Dr. Lauren Zajac of Mount Sinai Hospital, a pediatrician specially trained in environmental health, fielded questions by the board and residents and encouraged the district to implement an indoor air quality program in all its schools.

“As a pediatrician and a mom myself, I would want to make sure our schools have good air because nobody is doing that right now — let’s become a leader in the state when it comes to indoor air quality,” Zajac said over a Skype call in the cafeteria at William J. Brosnan School.

“I hope we don’t hear 10, 20 or 30 years down the road students are developing illnesses. No level of unnecessary exposure to these chemicals is at all acceptable … ignorance to this is no excuse.”

— Denise Schwartz

She assured the agitated residents in the room that moving forward is the best plan of action.

“We can’t change what happened in the past and I’m sorry it happened, and I know it’s stressful,” Zajac said. “I recommend channeling this passion and energy into making sure a really good program is put in place.”

The board assured Zajac and residents it has begun the process of implementing a Tools for Schools program, which shows school districts how to carry out a practical plan to resolve indoor air problems such as volatile organic compounds and mold “at little to no cost using straightforward activities and in-house staff,” according to the U.S.  Environmental Protection Agency website.

“Today we had a kickoff meeting for that program,” Northport Superintendent Robert Banzer said. “Tools for Schools is comprehensive and deals with anything having to do with air quality.”

Zajac’s appearance before the board followed consistent urging from the community for a longitudinal study of the school district to get to the bottom of four chemicals commonly found in perfumes and latex paints found in high concentrations in classrooms 74 and 75 in the K-wing corridor April 24. After an earth science teacher smelled fumes in the classroom, an investigation found the source to be a petroleum-based warehouse beneath the K-wing.

That discovery six months ago led to the closure of those rooms for the remainder of the school year. It remains off limits today.

The materials were removed and a series of air quality tests have since been conducted, one by a company called EnviroScience Inc. three days after the odor was first found. A second air quality test was performed by J.C. Broderick & Associates Inc. July 22.

Although the tests came up with “nothing that sounded the alarms from a health perspective,” according to Zajac whose team analyzed the data reports, parents have long feared for their children’s health in connection to the fumes.

Zajac pushed for the school and community to forego the longitudinal study as it may not provide the answers everyone is looking for. There are many unknown factors surrounding the possible exposures, and chemical levels in general are apt to change with each day, according to the specialist, resulting in an unreliable study.

“I think I’m going to explode if I hear ‘move forward’ one more time. You have to look back, you have to protect the children and staff that were there.”

— East Northport resident

“It would be very hard to draw conclusions as to whether a student’s visit to the nurse has anything to do with exposure concerns or unrelated illnesses,” she said, steering the conversation back to the future. “It could be done, but it would have so many limitations and I wouldn’t want it to take away effort from the most important thing — reducing the exposures from here on out.”

But some residents in the room weren’t as willing to let go of past problems within the school.

East Northport parent Denise Schwartz, whose three children have gone through the middle school, said she recently uncovered old newspaper articles documenting the school’s history of being a “sick building.” Mold, fungus and gas leading to headaches and fevers is not a recent problem here, Schwartz told Zajac.

“Every time it has come up, there has been some clean up that appeased people and then we move forward,” Schwartz said, implying negligence and incompetence by those in the school district. “I hope we don’t hear 10, 20 or 30 years down the road students are developing illnesses. No level of unnecessary exposure to these chemicals is at all acceptable … ignorance to this is no excuse.”

Mary Gilmore, a mother of two students whose classrooms were in the K-wing, urged for a longitudinal study to be done despite the unknown variables.

“Isn’t that the only way to know if there will be long-term health effects on the kids and staff that were in that building?” Gilmore said.

“My concern is that a study would be intensive and may not lead to any answers,” Zajac responded. “I’d be afraid so much would be put into this study and it wouldn’t be fruitful.”

Another East Northport resident, who asked to remain anonymous, agreed with the others that more focus should be on the past.

“I think I’m going to explode if I hear ‘move forward’ one more time,” she said, pleading for a study. “You have to look back, you have to protect the children and staff that were there.”

This version correctly identifies that Denise Schwartz’s children have already graduated from the middle school.

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If you have had a particularly nasty fight with your spouse or best friend today, consider this. How well did each of you sleep last night?

It may not come as a surprise that a good night’s sleep makes one feel calm and good natured the next morning. But how many of us consider the ramifications of poor or too little sleep one night on our behavior and relationships the next day? We may feel out of sorts, perhaps below our awareness radar, and that can lead to more difficult and even acrimonious interactions with those at work, in our daily routines and especially with our spouses. Even worse, it may affect our health.

A study at Ohio State University of 43 couples and how their bickering could influence their health tracked the subjects spouses most often argue over: managing money, spending family time together or an in-law intruding on their lives. According to an article in The New York Times Science section, “Relationship Problems? Try Getting More Sleep” by Tara Parker-Pope, Sept. 4, the study revealed that some couples argue calmly, even constructively, while others were “hostile and negative.”

The difference? The hostile couples were likely not getting enough sleep, usually less than at least seven hours. So before you give up on a relationship, consider the sleep factor. With enough sleep, you will still have disagreements, but the tone of the conflicts will probably be more patient.

The Ohio State study goes further. It purports to measure how marital discord together with sleep deprivation can negatively affect a person’s health. The way the university measured for this possible toxic effect was by taking blood samples from both members of the couple before and after an argument. The samples measured the level of inflammation in the body because inflammatory proteins have been linked with heart disease, cancer and other health problems. The results showed that “marital discord is more toxic to your body when you haven’t gotten enough sleep.”

Interestingly, when one member of the couple got adequate sleep, it mitigated the negative tone of the conflict, even if the other member was sleep deprived. So that suggests “a half-a-loaf is better than none” conclusion.

The article goes on to reveal that some 25 percent of couples sleep in separate beds, presumably in order to get more undisturbed rest. “And when one relationship partner doesn’t sleep well, his or her partner is more likely to report poor health and well-being.”

In conclusion: “The lesson, say the study authors, is that before concluding a relationship is in trouble, couples who regularly experience conflict should take stock not only of the relationship and how they are managing conflict, but also of their sleep habits.” The study was published in the May edition of the journal Psychoneuroendocrinology, hardly most people’s bedtime reading but offering an article to better understand the universal need in a marriage for adequate sleep.

In addition to all the authoritative information above, I can offer another nugget in the advice for marrieds department. Mine is anecdotal, not academic. Disagreements don’t go well if one or both members of a couple are hungry. Hunger starts out as insidious rather than full blown, and so it is often hard to identify the mood change when in the midst of a difficult discussion or even in an idyllic setting. But hunger can forcibly affect one’s outlook and certainly one’s patience.

I found this to be particularly true with my husband. (I’m not making a gender specific allegation here, just sayin’.) We could be having a perfectly lovely time at the zoo or some other outing, and for no apparent reason, he would begin to get cranky. The level of his crankiness would rise as we continued to stroll. Fortunately I eventually figured it out and began to carry protein bars in my pocket. At the right moment, I would pull two out and offer him one. Within merely a couple of minutes, all was again right with the world.

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Ring 10 raises money to help abandoned fighters, those down on their luck

Ring 10 boxers smile during a fundraiser. Photo from Facebook

By Kevin Redding

It was one of the few times Howard Davis Jr.’s wife saw him cry in public.

The Glen Cove native and Olympic gold medalist who made history in 1976 as the first amateur boxer to win the New York Golden Gloves tournament four years in a row had just about lost hope that he would ever get back his coveted awards, which were stolen from him and sold at a garage sale.

Matt Farrago with the late boxer and Olympic gold medalist Howard Davis Jr. Photo from Karla Guadamuz Davis

That all changed Sept. 13, 2015, when he was honored by Matt Farrago and his New York-based nonprofit, Ring 10, during a gala at Marina del Rey Caterers in the Bronx.

Davis, who was diagnosed with stage 4 lung cancer earlier that year at 59 and was on a personal mission to retrieve the mementos for his family before it was too late, was presented with four golden pendants.

Each one was a perfect replica of his lost golden gloves pendants, made and paid for by Ring 10. Veteran fighters from the nonprofit took turns placing them around his neck.

All Davis could do was bury his head in his hands.

“It was such an emotional moment and it was all because of Matt Farrago and Ring 10,” his wife Karla Guadamuz-Davis said, adding that the organization regularly helped pay for her now-late husband’s expensive medical treatment. “After Howard passed away on Dec. 30, 2015, I called Matt and said, ‘Thank you for giving Howard some joy during the last months of his life.’”

For Farrago, 56, a former middleweight boxer who lives in Greenlawn, helping retired fighters who have fallen on hard times is what he does every single day as the founder and president of Ring 10.

Formed in 2010 with a board of directors made up of ex-fighters, a cutman and some boxing advocates that meet once a month in the Bronx, the group stands as one of the few in the world that looks out for those who have been beaten in and out of the ring. Veteran boxers who are often discarded by managers and promoters at the top of their careers have been lost ever since, and that’s where Farrago comes in.

Ring 10 founder Matt Farrago with board member Richard Schwartz. Photo from Facebook

A majority of them wind up in physical and financial ruin because, unlike other professional sports like football, baseball or hockey, protected by NFL, MLB and NHL agencies, there’s no retirement or medical plan or structure in boxing for them to rely on.

You’re by yourself in the ring and in life, Farrago said.

“This is the rare sport that doesn’t take care of its own,” said Farrago, who was a top fighter in the 1980s until he was abandoned by his manager after losing a main event at Madison Square Garden. “There’s nothing — no safety net — nothing for these guys to fall back on. In boxing, if you don’t produce, you’re of no use. That’s the manager’s philosophy.”

He explained that while most athletes are drafted into the pros based on scholarships and achievements in college, that’s almost never the case for fighters, many of whom come up from the streets.

“If they make money, they think it’s going to last forever,” Farrago said. “Then they wake up with $150 in the bank. Whatever it takes, we try and get them back on their feet. We are the most effective club like this in the world.”

One of Ring 10’s proudest success stories is that of Iran “The Blade” Barkley, the World Boxing Council middleweight champion of 1988. The only guy to beat boxing legend Tommy Hearns twice, Barkley went from top of the world to homeless in the Bronx.

Matt Farago with elebrated boxing judge and analyst Harold Lederman. Photo from Facebook

“We were literally told there’s a fighter in the subway system living only with a bag of clothes and his championship belt,” Farrago said. “When Iran retired, he had nothing. We took him in, got him settled, got him a place to live, had social services kick in and about a year and a half ago he got married to a nurse.”

Barkley now serves on the group’s board of directors, which also includes top boxers Mark Breland and Richard Burton, and celebrated boxing judge Harold Lederman.

Since its inception, Ring 10 has raised thousands of dollars through events and banquets to help more than 30 top fighters struggling around the world.

They send monthly gift cards to boxers who can’t afford groceries and clothes, and checks to the families of those suffering from illnesses such as chronic traumatic encephalopathy — an extremely common degenerative disease among fighters that’s brought on by repetitive brain trauma, also known as “punch-drunk syndrome.”

For the last six years the group has helped out former two-time middleweight champion Gerald McClellan, who suffered an aneurysm and collapsed in the ring in 1995 and is now blind and 80 percent deaf; it frequently sends care packages to Charlie “White Lightning” Brown, who was once regarded as having the fastest hands in the fight game and now resides in a nursing facility in Illinois with fluid on his brain and difficulty speaking; and even provided a proper headstone for a Floridian fighter who died from injuries in the ring and was buried in a nameless plot in Flushing, Queens.

Matt Farrago. Photo from Facebook

While most of the boxers helped are between 45 and 60 years old, board members said they anticipate some younger guys currently in the ring coming to them for help.

“Boxers are basically pawns to be moved around,” said Richard Schwartz, one of the board of directors. “I also think there’s the feeling that a lot of people just don’t care — they don’t care about the modern-day gladiators who get in the ring to entertain them, who risk their lives. Once they hang up their gloves and a lot of the hits to the head kick in, many of them don’t even have any kind of medical insurance when they need it most. Where is Don King? Where is Oscar De La Hoyas? These people have made hundreds of millions of dollars from the sweat, blood and tears of these fighters, and where are they?”

To Burton, a boxer who has been swindled out of a fair share of money over the years, there’s hope as long as Farrago is around.

“Everything he says he does, he actually does,” Burton said. “He goes beyond what’s expected of him and he’ll help anybody. If you’re down on your luck, Matt will find a way to raise money for you. Ring 10 is helping as many fighters as we can.”

The Ring 10 7th Annual Fundraiser will be held at the Marina del Rey Caterers in the Bronx Sept. 24 from 11 a.m. to 4 p.m.

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Residents participate in a CDC survey to accumulate data on health and diets of Americans. Photo by Alex Petroski

By Alex Petroski

Suffolk County residents will play an important role in improving the health of their fellow Americans in 2017. The Centers for Disease Control and Prevention selected Suffolk as one of 15 counties nationwide to participate in its annual National Health and Nutrition Examination Survey, a data collection study that is used to draw conclusions about the health and diets of people in the United States.

The CDC is the nation’s health protection agency, conducting research in the hopes of preventing the spread of diseases and tracking their prevalence. The NHANES is a 55-year-old program that tracks health and diet trends in the U.S. by selecting counties based on demographics with the goal of accumulating a set of data representative of the entire population of the country.

Three CDC trailers will spend about six weeks parked in Stony Brook’s Research and Development Park to study Suffolk County residents. Photo from CDC

This is the second time Suffolk was observed as part of the survey since the turn of the century, according to study manager Jacque DeMatteis. The CDC arrived April 29 at Stony Brook University’s Research and Development Park in three mobile trailers outfitted with dozens of pieces of medical equipment, researchers and physicians to begin assessments on the approximately 600 Suffolk residents selected.

“It’s important because right now we’ve got all of these miracles happening with cancer research and things like that, without information that people help us to provide — a lot of it comes from here — [researchers] don’t have anything to draw on,” DeMatteis said of the purpose of the yearly survey during a tour of the CDC mobile facility May 19.

Charles Rothwell, director of the National Center for Health Statistics, reiterated the importance of accumulating the data in a statement.

“The survey is a unique resource for health information, and without it we would lack important knowledge about major health conditions,” he said. “The comprehensive data collected by NHANES has a far-reaching and significant impact on everything from the quality of the air we breathe, to the vaccinations you get from your doctor, to the emergence of low-fat and ‘light’ foods on the shelves of your grocery store.”

A young participant in the study is measured. Photo from CDC

The process for selecting participants within a county begins with about 1,500 addresses, and interviewers scour the area in the hopes of securing about 600 willing participants who also provide a representative sample of age ranges, genders, races and ethnicities and degrees of health. The selected participants who are willing to be examined then visit the mobile facility to be subjected to a variety of tests of blood pressure, diet, dental/oral health, vision and hearing, bone density, liver function and much more using high-tech scans not often available through traditional physicians.

DeMatteis made the case for selected participants making the trip to be studied despite some minor possible inconveniences.

“For the people who participate, they get their results back,” she said. “If anything abnormal comes up they’re contacted immediately. Our national health officer will contact them and we’ve had a couple of situations where it was kind of life-threatening situations and they were totally unaware of it.”

Participating adults also receive $125, reimbursement for travel expenses and the opportunity to receive credit for five hours of community service. Newborns and up are required for data collection, though specific scans and tests are not done uniformly across age groups.

“A lot of people do it for the exams, and in the past even more people had no means to get access to health care, so they came here because they’re going to get a whole lot of data about their health that they otherwise can’t afford to get,” DeMatteis said.

No medical procedures are offered at the site, though on occasion physicians are forced to recommend immediate treatment if anything concerning appears as a result of a test. Patients are also allowed to pick and choose which tests they’d like to participate in of the ones they qualify for. The CDC urges anyone selected to participate in the survey.

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Chris Zenyuh.
Chris Zenyuh.

I have had the privilege of teaching high school science (biology, chemistry and physics) for the last thirty years. For the last ten years, I’ve had the additional privilege and responsibility of developing and teaching an elective we simply call “Food Science.” It’s not your usual health class dietary guidelines, nor does it rehash the familiar mantras of counting calories and exercising to balance intake. Instead, we study the cultural, historical, scientific, political and economic contexts of our food system and how that system impacts our environments, both external and internal. This in turn enables students to make much more informed decisions about what they want to put in their bodies.

When it comes to sugars, confusion is the name of the game. There are dozens of ingredients that mark the presence of sugars in our food: maltodextrin, dextrose, invert sugar, cane sugar, high fructose corn syrup and starch, to name a few. Regardless of what the food industry calls them, your body sees basically three end products of their digestion: glucose, fructose and galactose. Which ones you eat, and how much, will dictate both their value and their danger to you.

You may have heard of three additional sugars — lactose, sucrose and maltose. Lactose is a combination of one glucose and one galactose. Also known as “milk sugar,” lactose is the nemesis of lactose-intolerant individuals who lack sufficient quantities of the enzyme that can digest it. Instead, bacteria that reside in their intestines get to process it, making painful amounts of gas as a by-product. Galactose can be converted to glucose in your body, but most individuals do not consume enough dairy to make this a source of concern.

Maltose is another type of sugar. It is a pairing of two glucose units and is the namesake for maltodextrin, etc. Consuming foods with maltose adds glucose to your diet — worth keeping track of as part of your total glucose consumption.

However, the most likely source of sugars in your diet is either sucrose or high fructose corn syrup. Sucrose, known also as table sugar, can be derived from sugar cane (cane sugar) or sugar beets (sugar.) Like lactose and maltose, sucrose is a paired structure, made of one glucose subunit and one fructose subunit. That is what your body absorbs regardless of the source (even organic.)

Sparing you the science behind its production, high fructose corn syrup is approximately half glucose, and half fructose too. Regardless of the marketing efforts by the Sugar Association and the Corn Refiners Association to make you believe one is better for you than the other, they end up, metabolically, in a virtual tie. Debating which to consume is a distraction from the consequences of consuming too much of either, or both.

Stock photo.

The consumption of sugar (the term is legally owned by the Sugar Association as the sole name for sucrose) used to be limited by the relative expense and difficulty in obtaining it from its tropical source. Now the record levels of corn production in America have made it relatively cheap to produce and distribute sugar’s nearly identical-tasting competitor, high fructose corn syrup. You can find it in soda for sure, but also in pickles, peanut butter, ketchup and pretty much anywhere sugar might be used for additional appeal to consumers.

This has paved the way for the combined consumption of these sweeteners to reach more than 150 pounds per year per person in America. This far surpasses the 60 pounds per year considered by some experts to be the maximum amount that can be metabolized without ill consequences including diabetes, cardiovascular disease, fatty liver, cataracts, personality and cognitive dysfunction, some cancers and (by the way) obesity.

Tying glucose and fructose consumption to the metabolic consequences noted above requires further discussion. And now, you are properly prepared for those lessons. As we say in Food Science class, “Chow!”

Chris Zenyuh is a science teacher  at Harborfields High School and has been teaching for 30 years.

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