Healthy Living 11/9/22 edition is published monthly by Anton Media Group. by Anton Community Newspapers

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HEALTHY LIVING • NOVEMBER 9 - 15, 2022 3B

Obesity Contributes To New Diabetes Cases

educing the prevalence of obesity may prevent up to half of new Type 2 diabetes cases in the United States, according to new research published in the Journal of the American Heart Association, an open access journal of the American Heart Association. Obesity is a major contributor to diabetes, and the new study suggests more tailored efforts are needed to reduce the incidence of obesity-related diabetes. Type 2 diabetes is the most common form of diabetes, affecting more than 31 million Americans, according to the U.S. Centers for Disease Control and Prevention. The risk factors for Type 2 diabetes include being overweight or having obesity; being over the age of 45; having an immediate family member diagnosed with Type 2 diabetes; being physically active less than three times per week; or a history of gestational diabetes (diabetes during pregnancy). Type 2 diabetes is more common among people who are Black, Hispanic or Latino, American Indian, Alaska Native, Pacific Islander or Asian American. The number of deaths due to Type 2 diabetes in people younger than 65 is increasing along with serious complications of the condition, including amputations and hospitalizations. In addition, Type 2 diabetes impacts heart disease and stroke risk: adults with Type 2 diabetes are twice as likely to have a heart attack or stroke than people without diabetes. Type 2 diabetes can be prevented or

delayed with healthy lifestyle changes, such as losing weight, eating healthy food and being physically active. According to the National Diabetes Prevention Program, behavior changes have been shown to help people with prediabetes lose five to seven percent of their body weight and reduce their risk of developing type 2 diabetes by 58 percent (71 percent for people older than age 60). Researchers examined the prevalence and excess risk of Type 2 diabetes associated with obesity. “Our study highlights the meaningful impact that reducing obesity could have on Type 2 diabetes prevention in the United States. Decreasing obesity needs to be a priority. Public health efforts that support healthy lifestyles, such as increasing access to nutritious foods, promoting physical activity and developing community programs to prevent obesity, could substantially reduce new cases of Type 2 diabetes,” said the study’s first author Natalie A. Cameron,

M.D., a resident physician of internal medicine at the McGaw Medical Center of Northwestern University in Chicago. Researchers used information from the Multi-Ethnic Study of Atherosclerosis (MESA) and four pooled cycles (20012016) of the National Health and Nutrition Examination Survey (NHANES). MESA is an ongoing, longitudinal study of 45 to 84-year-olds who did not have cardiovascular disease upon recruitment. MESA data included in this study was collected during five visits from 2000 Obesity is a major to 2017 at six contributor to centers across diabetes. the U.S. NHANES is a cross-sectional study of the American population that takes place every other year using patient questionnaires and examination data. “Our study confirms there is a higher prevalence of obesity among non-Hispanic Black adults and Mexican-American adults compared to non-Hispanic White adults. We suspect these differences may point to important social determinants of health that

contribute to new cases of Type 2 diabetes in addition to obesity,” said Cameron. For this analysis, authors limited data to participants ages 45 to 79 years old. They included only those who were non-Hispanic White, non-Hispanic Black or Mexican American and who did not have either Type 1 or Type 2 diabetes at the beginning of the study. Researchers calculated both the prevalence of obesity and the excess risk of Type 2 diabetes associated with obesity. “Additionally, the obesity epidemic has collided with the COVID-19 pandemic,” said Sadiya S. Khan, M.D., M.Sc., the study’s senior author and an assistant professor of medicine and preventive medicine at Northwestern University’s Feinberg School of Medicine. “The greater severity of COVID-19 infection in individuals with obesity is concerning because of the growing burden of adverse health consequences they could experience in the coming years; therefore, further efforts are needed to help more adults adopt healthier lifestyles and hopefully reduce the prevalence of obesity.” This analysis included only middle-aged to older adults without cardiovascular disease who were non-Hispanic White, non-Hispanic Black or Mexican-American, so results may not be generalizable to the entire U.S. population. Future research is required to assess the burden of obesity on new cases of Type 2 diabetes in other age groups and racial and ethnic groups. —American Heart Association

Edmond Hakimi Tapped As Wellbridge Medical Director Wellbridge Addiction Treatment and Research (Wellbridge), a Joint Commission Gold Seal of Approval recipient for Behavioral Health Care and Human Services Accreditation, recently announced that Dr. Edmond Hakimi has been appointed medical director at Wellbridge. He brings invaluable expertise to the Wellbridge team and will be a trusted resource for patients and staff. “Dr. Hakimi brings a passion and desire to provide an unparalleled level of care to those with substance-use disorders, and we welcome him to Wellbridge,” said Dr. Christopher Yadron, CEO of Wellbridge. “His experience and innovation in addiction treatment, coupled with an already robust staff of caring, dedicated professionals, create a new dynamic of hope and success for the patients we treat.” Hakimi, a resident of Old Bethpage,

is a highly renowned board-certified Internal Medicine physician with fellowship training in Addiction Medicine from Brigham and Women’s Hospital, an affiliate of Harvard Medical School, where he currently serves as Part Time Faculty. He received his Bachelor of Science degree from St. John’s University, in New York, with a major in Biology and a minor in Chemistry. Hakimi earned his Doctor of Osteopathic Medicine from the New York College of Osteopathic Medicine degree and completed his Internal Medicine residency at Stony Brook Southampton Hospital. He specializes in treating patients with substance-use disorders and concurrent psychiatric diagnoses while conducting clinical research to develop novel treatments for these disorders. As Wellbridge’s Medical Director, Hakimi’s goal will be to provide exceptional care to those with substance-use

disorders and wrap-around services, including Medication for Addiction Treatment, Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and Motivational Interviewing. In addition to his clinical work, Hakimi dedicates his time to improving the lives of people in recovery or seeking recovery, from substance-use disorder, including by helping establish Nassau County’s first Mobile Addiction Recovery Treatment program. He also serves as the president of the Long Island Recovery Association, a nonprofit organization that, through education and advocacy, aims to eliminate the negative public perception of addiction and achieve full parity for treatment and recovery support services on demand. For additional information, visit www. wellbridge.org. —Wellbridge Addiction Treatment and Research

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4B NOVEMBER 9 - 15, 2022 • HEALTHY LIVING

Pregnancy And Your Liver

iver test abnormalities are not uncommon in pregnancy and even minor test elevations should be addressed. Liver test abnormalities during pregnancy can create significant anxiety in both the pregnant woman and the expectant father. This anxiety is made worse by the simple fact that liver disease in pregnancy is poorly understood by many medical practitioners. The good news is that most liver test abnormalities seen in pregnancy resolve on their own with no effect on either the mother or newborn child/children. Many times, the cause is unknown and tends to not recur with subsequent pregnancies. Despite this reassuring fact, a physician must evaluate liver test abnormalities found during pregnancy as significant liver disease can occur during this period. The most common cause of abnormal liver tests in pregnancy are not specific for pregnancy and are mostly due to viral infections or medication use. There are, however, several important conditions specific for pregnancy that need to be

called hyperemesis gravidarum. Abnormalities in liver tests are common in this condition. The development of hyperemesis gravidarum is associated with the first pregnancy, young age, smoking and obesity. The cause is unknown. If severe and the mother has difficulty maintaining their weight while pregnant, the fetus is at increased risk of intrauterine growth retardation. This condition, however, is not associated with any long-term liver disease. Intrahepatic cholestasis of David Bernstein, MD pregnancy is another condition unique to both pregnancy and tends to occur in otherwise addressed. Nausea and vomiting are quite healthy women. This condition common during the first trimester occurs in the third trimester of pregnancy. So common, in fact, of pregnancy and is marked by the development of severe that morning sickness is thought to be one of the first signs of preg- itching. Liver test abnormalities are common. Many patients nancy. Most morning sickness develop jaundice. The cause is either is easily managed or goes away on its own. Occasionally, the unknown although hormonal nausea and vomiting will become changes are felt to play a role in its development. It occurs more protracted requiring hospitalcommonly amongst people of ization for intravenous fluids. Latin American or Scandinavian At this stage, morning sickness descent. If mild, the itching is has evolved into a condition

THE SPECIALIST

treatable with bile-acid resin binders such as cholestyramine. Ursodeoxycholic acid and phenobarbitol have been successfully used to treat itching. The only definitive therapy, however, is delivery. With delivery, itching usually resolves within days and liver test abnormalities usually normalize within several weeks. This is a benign but frequently recurrent condition for the mother. Patients who develop this need to be followed in the future for the development of primary biliary cholangitis or PBC. This condition, however, is not benign for the fetus, as it is associated with an increased rate of fetal distress, premature births and stillbirths. Two other conditions that are unique to pregnancy are worthy of mention. The HEELP syndrome (hemolytic anemia, elevated liver enzymes and low platelets) and acute fatty of liver of pregnancy are conditions which occur in the third trimester. The causes of these disorders are also unknown but a growing body of research suggests that acute fatty liver of pregnancy may be an inherited

disorder. People with these conditions usually complain of fatigue, abdominal pain, headache, nausea or vomiting. Once diagnosed, these conditions need to be treated immediately with delivery as both conditions can rapidly progress to coma and maternal death. Rarely, patients with acute fatty liver of pregnancy may require a liver transplantation. Within two weeks of delivery, symptoms generally resolve as the event is self-limited. If delivery goes well, there are no long-term sequelae associated with either condition. Both conditions, however, are associated with an increased risk of maternal death, fetal intrauterine growth retardation and fetal death. The important take home point is that all liver test abnormalities during pregnancy must be evaluated by a doctor. While there is no need to panic when these abnormalities are discovered, it is prudent that the pregnant mother seek appropriate medical care. —David Bernstein, MD, MACG, FAASLD, AGAF, FACP

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6B NOVEMBER 9 - 15, 2022 • HEALTHY LIVING

National Family Caregivers Month Caregiving in BIPOC communities

amily caregivers exist across all demographics—people providing care to their loved ones come from every age, gender, socioeconomic status, and race/ ethnicity. However, not all identities are represented among caregivers at rates proportional to the general population and they don’t all share the same experiences. For a long time, caregiving research and media portrayals centered around White caregivers—mostly White, middle-aged, middle-class women. Currently, nearly 40 percent of caregivers identify as Black, Indigenous, or People of Color (BIPOC). Within each BIPOC racial/ethnic group, the rates of caregiving are higher than in White demographics. While BIPOC caregivers tend to receive more support from family and friends than White caregivers do, they face a lot of challenges that White caregivers don’t experience. On average, BIPOC caregivers have lower socioeconomic status. Studies have found that Black and Hispanic caregivers often feel ignored in medical settings and left out of crucial care discussions by staff. Asian-American caregivers don’t utilize professional

support services as often as others, likely because of limited culturally relevant services. While most caregivers feel as though caregiving is the “right” thing to do, BIPOC individuals often see it as an expected part of life that each generation participates in at some point. For many, there’s no decision to be made about whether to be a caregiver—it is just a role they assume without much conscious thought. In some cultures, the role of caregiving is based on gender and birth order. While White individuals tend to take on the caregiving role due to feelings of personal responsibility, caregiving is a cultural expectation in many BIPOC communities and families.

Race Breakdown

Among caregivers in the United States, the race breakdown is as follows: 62% identify as White 17% identify as Hispanic (nonWhite, non-Black) 13% identify as Black 6% identify as Asian-American Within each of these demographics, the prevalence of caregiving varies: Hispanic: 21% Black: 20.3% Asian-American: 19.7% White: 16.9%

Caregiver Age

On average, BIPOC caregivers are younger than White

caregivers. The average age of caregivers by racial/ethnic group are: White: 53.5 years old Asian-American: 46.6 years old Black: 44.2 years old Hispanic: 42.7 years old Sixty-two percent of White caregivers are over the age of 50, while it’s more common for BIPOC to be caregivers in early adulthood. The largest age demographic among each racial/ ethnic group are: Hispanic: 18-34 (38% of Hispanic caregivers fall in that age range) Black: 50+ (38%) Asian-American: 50+ (44%) White: 50+ (62%) In both the 18-34 and 35-49 age brackets, there is a higher percentage of Hispanic, Black, and Asian-American caregivers (individually) than White caregivers.

Time Spent Caregiving

Hispanic and White caregivers spend the most time providing care: Hispanic: 80 hours per month White: 50 hours per month

Black: 45 hours per month Asian-American: 45 hours per month

Employment

Across ethnicities, approximately 4 in 10 caregivers are unemployed: Hispanic: 43% unemployed White: 40% unemployed Black: 40% unemployed Asian-American: 35% unemployed Caregiving can disrupt an individual’s employment, and many caregivers across ethnicities have needed to adjust their workload or schedule to accommodate their other duties. In some cases, this leads to retiring early or quitting: Black: 19% retire early/quit White: 15% retire early/quit Hispanic: 13% retire early/quit Asian-American: 6% retire early/ quit Many employed caregivers have told their supervisor about their caregiving role, but a number of people across ethnicities have not told anyone at work:

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Black: 36% Hispanic: 31% Asian-American: 23% White: 20%

Financial Impact

While far greater percentages of caregivers in all groups describe their financial well-being as good or excellent versus poor, the self-described financial well-being of caregivers varies substantially among racial/ethnic groups: Asian-American: 61% excellent/good, 15% poor White: 59% excellent/good, 14% poor Hispanic: 46% excellent/good, 17% poor Black: 41% excellent/good, 19% poor While most caregivers across all ethnicities report that their financial situation did not change upon becoming a caregiver, around 1 in 5 say it worsened. Of those who reported a worsening financial situation, the racial/ethnic breakdown is: Asian-American: 22% White: 19% Black: 19% Hispanic: 16%

General Health

People caring for a close relative are at a greater risk of declining health as a result of caregiving than those caring for distant relatives

or unrelated individuals. Among racial/ethnic groups, White and Asian-American caregivers are more likely to say caregiving has negatively impacted their health: White: 26% Asian-American: 24% Hispanic: 15% Black: 14%

Mental Health Impact

The emotional burden of caregiving is significant across racial/ethnic groups, though White and Hispanic caregivers report higher rates of distress: White: 56% report feelings of isolation or loneliness; 32% report feelings of anxiety Hispanic: 52% report feelings of isolation or loneliness; 34% report feelings of anxiety Black: 43% report feelings of isolation or loneliness; 23% report feelings of anxiety Asian-American: not reported Many people find caregiving to be rewarding, but it isn’t without challenges. If you’re providing care for a loved one and feel like your mental health is worsening, you aren’t alone. Take a free online screening (www. mhascreening.com) to determine if what you’re experiencing may be a sign of a mental health condition. —Mental Health America (MHA)

New Yorkers Have Among The Best Levels Of Lung Health

he Lung Institute, a source for pulmonary It’s no secret the severe damage that cigarette information for better lung health, including smoking causes to human health (both the tobacco disease prevention and management, comuser, and those around them), as well as the missioned a national study to establish a ranking of surrounding environment. Smoking increases the lung health across America, over a five-year period. risk of developing conditions, such as lung cancer, This data analysis factored the following statistics emphysema and chronic obstructive pulmonary from the last five years: the change in smoking rate disease—not only for the tobacco user themselves, in each state, as well as the change in pollution lev- but for those around them as well. Non-smokers el (measured in PM2.5, which is the average daily who are involuntarily exposed to secondhand density of fine particulate matter in micrograms smoke are inhaling many of the same toxins and per cubic meter). chemicals as tobacco users directly. Even This ranking determined that brief exposure to secondhand smoke Virginia placed in position #1. can have immediate adverse effects Virginia was the state with the on blood vessels, increasing the best lung health improvement risk of having a heart attack. over five years, experiencing Cigarettes are also the a five percent decreased biggest contributing factor to smoking rate, as well as a litter on the planet, leeching decreased volume of air polmore than 7,000 toxic chemlution over this time (PM2.5 icals into the environment decreased by five). when discarded. Tobacco New Yorkers emerged as smoke is also a big contribhaving among the best lung utor of air pollution particles. health in America. They experienced a one percent However, when it comes to kicking the habit of decrease in smoking rates more than five years, and smoking, it’s never too late. Quitting could add as a decline in PM2.5 (-5.1), placing in #17 position much as a decade onto your life, compared to if you overall. continued the smoking habit. In addition, it conOn the other hand, at the opposite end of the tributes positively to a decreased overall smoking Tue. - 10/25/2022 - 1:23:00 PM SFAD_00258752 rankings, Texas emerged in last place (#50) with rate, which improves the health of people, as well the least healthy lung health trend over five years. as the health of the surrounding environment. The Lone Star State had a one percent decrease in smoking rates, and a 2.3 decrease in air pollution. —The Lung Institute

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8B NOVEMBER 9 - 15, 2022 • HEALTHY LIVING

ADELPHI NEW YORK STATEWIDE BREAST CANCER HOTLINE & SUPPORT PROGRAM

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