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Vol. 17 • Issue 9 • June 2020

DIABETES MANAGEMENT

ALSO INSIDE New Diabetes Research

Caring for Pets with Diabetes

Diabetes and Oral Health


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Diabetes Management By The Numbers What’s New in Diabetes Research What Should You Do if Your Pet Has Diabetes? Psychological Factors Facing People with Diabetes and Their Caregivers Good and Bad Sugars Diabetes Can Affect Oral Health

COLUMNS INTEGRATIVE MEDICINE: Mindful Breathing GENERAL DENTISTRY: Gum Problems FAMILY DOC: Taking Safety Seriously

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PET HEALTH EVENTS CALENDAR NATURE'S BEAUTY FOOD BITES IN THE NEWS

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JUNE 2020: DIABETES

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EDITOR Dear Friends, This issue on diabetes really hits home for me. My mother was diagnosed with diabetes when she was in her late 70s. Soon after her non-diabetes-related death, my brother, Tony, went into a diabetic coma. We never even knew he had diabetes, but it explained a lot – why he was always so skinny and thirsty and always had headaches. He subsequently recovered and has done so well that he no longer needs insulin. My other brother, Ted, developed diabetes, too, and subsequently lost a toe, part of a foot and then half his leg to amputation because of complications. Then in January, after undergoing surgery to re-open the vein to his good leg, Ted unexpectedly died. Our family is still reeling from the shock. He was only 63 years old. It has made me more diligent to be sure I watch my diet and exercise so I do not succumb to this family scourge. Diabetes is devastating. Don’t take it lightly. If you have it, work with your physician to stay healthy and avoid these serious complications. Please. Ted, this one’s for you. Here's to your health,

Tanya

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DIABETES

MANAGEMENT BY THE NUMBERS

1 IN 4

PEOPLE DON’T KNOW THEY HAVE DIABETES


IT IS WISE TO SEEK WAYS TO MANAGE ONE’S DIABETES.

LEXINGTON’S NEWEST LUXURY PERSONAL CARE AND MEMORY CARE

By Dr. Tom Miller, Staff Writer Diabetes is a metabolic disorder characterized by high blood sugar levels over a prolonged period. The pancreas no longer produces enough insulin or the cells stop responding to the insulin that is produced, so glucose in the blood cannot be absorbed into the cells. Symptoms often include frequent urination, lethargy, excessive thirst and hunger. Diabetes is the No. 1 cause of kidney failure, lower-limb amputations and adult blindness. More than 30 million American adults have diabetes, and one in four of them don’t know they have it. Diabetes is the seventh leading cause of death in the United States. High blood glucose readings are the most obvious symptom of uncontrolled diabetes. As diabetes raises blood sugar levels, some individuals with diabetes may think it is normal to have high blood glucose. However, diabetes is a manageable disease. The secret is knowing your numbers. The American Diabetes Association recommends people with type 2 diabetes aim for blood sugar levels that are as close to normal as possible. This is called tight control. The better your blood glucose control is, the less likely you are to have diabetes-related health complications that may include kidney, eye, brain and nerve damage, as well as the potential for heart attacks and strokes (vascular damage). Blood sugar or glucose levels are read on a glucometer. Readings before a meal should be around 70-130 mg/dL (5.0-7.2 mmol/L), while blood sugar readings after a meal should be about < 180 mg/ dL (10 mmol/L). People with diabetes should also know their A1C. Hemoglobin is the protein found in red blood cells that gives blood its color and carries oxygen throughout the body. The HgbA1C (glycosylated hemoglobin) test is commonly referred to as one’s A1C. The A1C goal for people without diabetes is less than 6 percent. However, for people with diabetes, the goal is less than 7 percent. The A1C percentage corresponds with an actual blood glucose level. For example, an A1C of 7 percent is equal to an average blood sugar level of 154 mg/dL (8.6 mmol/L), and an A1C of 10 percent is equal to a blood sugar level of 240 mg/dL (13.3 mmol/L). Current recommended levels of blood sugar and A1C equal to 7.0 is recommended. This is a key number because it reflects a person’s overall blood sugar control. It is wise to seek ways to manage your diabetes. That includes diet, exercise, medication and daily diligence of blood sugar levels. If you are unsure about your numbers, discuss them with your health care provider. Knowing your numbers will give you a much better understanding of how well you are managing your diabetic health. The higher the levels on these two measures – blood glucose and A1C – the greater your risk of developing diabetes complications. Take the time to meet with your healthcare provider to learn more about your blood glucose levels and your A1C if you need help improving those numbers. Sources and Resources

• American Diabetes Association (www.diabetes.org) • Centers for Disease Control and Prevention (www.cdc.gov/diabetes)

About the Author: Thomas W. Miller, M.S., Ph.D., ABPP, is a Professor Emeritus and Senior Research Scientist, Center for Health, Intervention and Prevention, University of Connecticut, and Professor, Department of Gerontology, College of Public Health, and Department of Psychiatry, College of Medicine, University of Kentucky.

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WHAT’S NEW IN DIABETES RESEARCH TAKE EXTRA PRECAUTIONS IN THE LIGHT OF COVID-19 By Jamie Lober, Staff Writer Diabetes is an all-too-common health condition. While there are great strategies for management, those affected and their loved ones can be comforted by knowing new research is taking place each day and new developments are helping those with diabetes live better. For people with type 2 diabetes, a new wearable, patch-like insulin delivery system was discovered in April 2020. The device, called V-Go by Valeritas, Inc., is a small 24-hour disposable mechanical device used with rapid-acting insulin in adults. Studies showed it improved patients’ A1C and offered good blood glucose control. New research suggests saliva could be used as a cheaper, painfree alternative to checking blood as a way to monitor diabetes. Researchers say saliva reflects physiological functions of the body such as nutritional, hormonal, emotional and metabolic, which can provide insight to diabetes management. This way of checking is noninvasive and more cost effective and could help patients with both type 1 and type 2 diabetes. With COVID-19, people with both types of diabetes have to take extra precautions. They must remember that during times of stress or illness, blood sugars can change quickly, meaning they will be very high or very low. Monitor your blood sugar frequently, ideally using a continuous glucose monitor, and continue diabetes medications as usual. Staying hydrated is important. The Diabetes Research Foundation suggests drinking at least one glass of fluid every hour. If sugar levels are high, drink water. If they are low, drink fruit juice or Gatorade. It is a good idea to stock up on diabetes supplies and over-the-counter medications so you can treat a fever or another symptom without having to go out. It is also smart to have at least enough insulin for the week ahead. Lifestyle can make a difference. Harvard University has identified four dietary changes that can impact your risk for type 2 diabetes. People with and without diabetes should choose whole grains over refined ones and other highly processed carbohydrates. They should avoid sugary drinks and drink water instead. Eat healthy fats such as the polyunsaturated fats found in liquid vegetable oils, nuts and seeds. And limit red meat, choosing poultry or fish instead.

NEW DEVELOPMENTS ARE HELPING THOSE WITH DIABETES LIVE BETTER.

The American Diabetes Foundation says having extra weight means having extra risk. The best way to maintain a healthy weight is to cut back on calories and fat. Eat breakfast every day and stay physically active most days of the week. It can help to walk with a friend or neighbor so you will have someone to hold you accountable and support you on your journey to good health. Another most interesting finding is that someone’s grip strength tells a lot about their health. Studies have connected low muscular strength to increased risk for type 2 diabetes. Since type 2 diabetes is reversible if caught early, an easy way to assess your risk of diabetes is by using a handgrip dynamometer. The device is low cost and easy to use and carry around. If your grip strength is low, other diagnostic tests are recommended. Researchers hope to create a fully automated artificial pancreas eventually. Many clinical trials are currently underway, and more data is being gathered by the day. Staying informed and aware of your options as well as knowing what you can do on the side of prevention makes it easier to understand and navigate living with diabetes.

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WHAT SHOULD YOU DO IF

YOUR PET HAS DIABETES? MONITOR YOUR FURRY FRIENDS AND CHECK WITH YOUR VET

DIABETES AND YOUR PET Cats Diabetes in cats is thought to be an autoimmune disease, says Merck Animal Health. Most cats are older than 6 years when they develop diabetes. If you monitor your cat and it does not have any other health problems, it should be able to have a normal life expectancy. Some cats who start out with insulin-resistant type 2 diabetes can progress to insulin-deficient type 1 diabetes over time. Reducing total carb intake or adding fiber may help reduce the insulin dosage. For type 2 diabetes, insulin may be necessary to control hyperglycemia.

Dogs Dogs are usually between ages 4 to 14 years old when diagnosed; most are diagnosed at about age 7 to 10 years. Diabetes occurs in female dogs twice as often as in male dogs. Certain dog breeds are predisposed to diabetes, according to PetMD and the American Veterinary Medical Association. A highfiber diet is usually recommended. Avoiding snacks in between meals is important for dogs.


June 2020 By Angela S. Hoover, Staff Writer It’s estimated that one in 300 adult dogs and one in 230 cats in the United States have diabetes, according to Merck Animal Health. Diabetes can develop in cats and dogs of any age, although it is more common in older pets. There is no clear distinction between type 1 and type 2 diabetes in animals, says the American Veterinary Medical Association. Diabetes in cats and dogs is more fluid. Risk factors, symptoms, diagnosis and treatment are the same in both dogs and cats. There is no single cause of diabetes in cats and dogs, but steroid medications can induce it, according to PetMD. Underlying conditions such as pituitary or adrenal disease, overactive thyroid gland in cats and overactive adrenal glands in dogs can contribute to the development of diabetes. Obesity can be a risk factor and/or significantly affect a pet’s response to diabetes treatment. Blood work and urinalysis will confirm which condition is afflicting your pet. Managing your pet’s diabetes is very similar to that of humans. There are similar medica-

tions, equipment and monitoring methods. With proper monitoring, treatment, diet and exercise, your pet can lead long, healthy life. Left untreated, diabetes can lead to liver dysfunction and a life-threatening condition called ketoacidosis. Without aggressive treatment, diabetic ketoacidosis can cause brain swelling, kidney failure, pancreatitis and death. Symptoms of diabetes in pets include excessive water drinking, increased urination, weight loss, decreased appetite, lethargy and poor coat condition. Keeping your pet’s blood sugar near normal levels and avoiding lifethreatening levels that are too high or too low is the foundation for treating their diabetes. This will entail regular exams, blood and urine tests and watching your pet’s weight, appetite, drinking and urination. Your vet will likely prescribe insulin, but it can take some time to find the perfect dose. The dose may be adjusted periodically, based on results from monitoring. Insulin injections are given twice a day, usually with a meal. (Feed your pet at regular times to help keep blood sugar levels balanced.) Signs of insulin overdose include weakness, tremors or seizures and loss of appetite. Contact your vet or an emergency clinic immediately if you observe any of these signs.

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High-fiber diets are beneficial for both cats and dogs with diabetes. Wet food is preferable as it is generally lower in carbohydrates. And just like for humans, daily exercise is recommended. Your vet will monitor your pet for long-term complications such as cataracts, hind leg weakness due to low blood potassium, high blood pressure or lower urinary tract infections. Remission is possible in certain cases, says Dr. Jennifer Larsen, a diplomate of the American College of Veterinary Nutrition and professor of clinical nutrition at the University of California Davis. “In cats, the loss of body fat can result in remission, while for dogs, improved control [of symptoms] is an important goal,” said Larsen. “Likewise, reversing inappropriate or unwanted weight loss in a thin dog or cat is also important.” SOURCES

• American Veterinary Medical Association (www.avma.org) • Merck Animal Health (www.merck-animalhealth.com) • PetMD (www.petmd.com)

MANAGING YOUR PET’S DIABETES IS VERY SIMILAR TO THAT OF HUMANS.

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pet health

Looking for the best pet care options for the health and wellness of your 4-Legged friends? Then welcome to our “Pet Health” Section, where we will bring you the finest businesses in Central Kentucky that will tend to the care and well-being of our furry loved ones. In this issue we feature “Uptown Hounds,” an upscale pet resort in downtown Lexington that will pamper your pooch in the way he or she deserves, as well as all the good things that are happening at the Lexington Humane Society.

ANIMALS FIND SECOND CHANCES

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AT LEXINGTON HUMANE SOCIETY

he life-saving work the Lexington Humane Society (LHS) provides is accomplished by our community’s desire to give animals another chance at a healthy and happy forever. Every program LHS has in place guides animals in their journey to adoption day. The Second Chances program was developed as a way to provide extraordinary treatment for animals in need of special medical intervention that would otherwise prevent them from thriving. Second Chances funding assists with inten-

sive surgeries, diagnostic work, equine rescue, prescriptions, formula for foster care and special food – resources that many animals in need would typically not receive. Having an on-site veterinarian and in-house pharmacy allows us to stretch our dollars further, in turn helping a greater number of special-needs animals each year. Typically, an amputation surgery would cost at least $800. However, we are able to perform the same surgery on-site for approximately $250. Bladder surgery normally costs up to $3,000, yet our cost is only

$1,000. The average amount spent on each Second Chances animal is approximately $1,000. We are reminded, now more than ever, that we must lean on each other for support. Even during these unprecedented times, we are sure our community will continue to rise to the occasion when there are animals in need. Every dollar counts when providing life-saving care to animals waiting to meet their forever families. They need us. We need you. Donate today to give an animal their second chance.


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SUMMER MEANS G” IN P P O H S P O T -S E “ON S AT UPTOWN HOUND

By David Bryan Blondell, Special Sections Dir.

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s a pet owner, are you tired of dragging your beloved pooch to two, three or four different places for the services and products your dog needs? Then kick off your summer by kicking away all those extra trips: Give Uptown Hounds a try for “One-Stop Shopping” for grooming, daycare, boarding, food, gifts and numerous playtime options.

America’s Uptown Hounds Luxury Resorts was created as an all-inclusive, high-quality, highenergy environment where your four-legged family member can play, primp, relax and stay. And let’s face it — you AND your pooch deserve the best single place available when it comes to providing them everything they need. Conveniently located in downtown Lexington near office buildings, the University of Kentucky campus and all of the downtown hospitals and healthcare facilities, Uptown Hounds’ guests — pets and their owners — have a multitude of luxurious amenities to enjoy.

Uptown Hounds features large, plush hotel suites for short- and long-term boarding, private daycare rooms, a top-notch grooming Salon & Spa and a boutique with the finest of toys, treats, food and pet-related merchandise. In addition, extremely large heated indoor and manicured outdoor play areas provide your pooch the most fun and friendly environment possible. Moreover, the beautiful marble floors and walls and the upscale fixtures that are part of the facility’s luxurious decor simply reflect the upscale treatment your four-legged member of royalty deserves. UPTOWN Continued on Page 12

Enjoy “ONE-STOP SHOPPING” at Uptown Hounds!

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pet health by Uptown Hounds

In addition to Uptown Hounds’ weekly daycare services, a special new weekend daycare schedule is now available: Saturday and Sunday from 8 a.m. to 5:30 p.m.! Also inquire about the “Daycare Referral Bonus.”

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UPTOWN continued from Page 11

The Daycare Services at Uptown Hounds are considered second to none, with newly expanded weekday hours of 6:30 a.m. to 7:30 p.m. Monday through Friday to make it more convenient for working owners. In addition, there are new weekend daycare hours: Saturday and Sunday from 8 a.m. to 5:30 p.m. Once there, the friendly Pet Services Staff makes sure your dog is well-cared for and is having a happy, fun stay with up to three play-time sessions with its new-found friends (grouped by weight and activity level). Individual playtime and extra attention is also offered, as is supervised usage of the popular 30-foot-by-50-foot outdoor pool during its seasonal operation. Which brings us now to summertime, the most anticipated time of the year for owners and pets alike: the opening of the oversized doggie-only pool! Fondly referred to as the “Cool Pool,” this very popular and in-demand venue provides hours of fun for Uptown Hounds’ clients (and guests; dog vaccines required) to bring and watch their dogs romp and stomp and have the best time of their lives! Towels and lifejackets are available; the staff will provide supervision for pool use during daycare or boarding visits. For further enjoyment, poolside chairs

pet

and tables with large umbrellas surround the pool, giving shade and a comfortable place to rest for owners and swimmers alike. Summer is here, and “One-Stop Shopping” is a reality that will fulfill your pet’s needs at Uptown Hounds. They recognize the proper, professional care of your pets is among the most important considerations you have — and for anyone wanting to give as much love and special care to your dogs as they give you, this summer please give America’s Uptown Hounds Luxury Resorts a try. Please visit their website at www.UptownHounds.com or call Guest Services at (859) 2552275. A new texting service is now available as well — text any questions or boarding requests to (859) 255-2275. Uptown Hounds is conveniently located just off South Broadway at 466 Angliana Avenue, just a half mile from downtown and a block from The Red Mile. They invite you to a quick tour of the facility and look forward to welcoming you and your dog as a part of the Uptown Hounds family! Note: As the conditions surrounding the pandemic and its restrictions change, please call Uptown Hounds or visit their Website to verify what services are currently being offered or affected.

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Integrative Medicine.

MINDFUL BREATHING

REDUCES STRESS

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he current pandemic is a global stress we are all experiencing together. By managing our own stress, we contribute to the relief of stress throughout society. Research shows mindfulness can help you cope with stress and improve your health, allowing you to better serve others in need. Mindful breathing is a simple stress-reduction practice that anyone can do, and it can help reduce physical, mental, emotional, behavioral and relationship stressors. We rush around and hurry all day being busy, usually ignoring the wonder of our senses and the wisdom of our bodies. Our thinking and imagination are so much in the past and the future. We often allow our regrets, fears and anxieties to dominate our experience, often ignoring our amazing human body as it breathes and functions in miraculous ways. Mindful breathing helps you shift your attention from the busyness in the mind to the wisdom of your body.

Mindfulness of One Breath: A Five-Second Practice I love this simple, short mindfulness practice. It helps you break the habit of worrying about the past and the future. You can do it for three breaths – just 5 seconds – or longer. As you breathe in, say to yourself, “I am breathing in and I know I am breathing in.” As you breathe out, say to yourself, “I am breathing out and I know I am breathing out.” This can be done with eyes open or closed almost anywhere at almost any time.

Three-Minute Breathing Space The psychologists who created mindfulness-based cognitive therapy (MBCT) emphasize the importance of intentionally shifting our attention from our “doing mode” (which involves a lot of thinking about the future or the past) to our “being mode” (which involves being more fully in the present in a non-striving and non-judgmental way). You can spend a minute or less on each of these three steps. 1. Attend to what is. This first step invites attending broadly to one’s experience NOW, noting it without the need to change what is being observed. 2. Focus on the breath. This step narrows the field of attention to a single-pointed focus on the breath moving in and out and throughout the body. 3. Attend to the body. This step widens attention again to include the body as a whole and any physical sensations that are present. Any time you feel stressed or simply remember to take a self-care pause, you can intentionally shift your attention, checking in with your breath and your body, and then resume your activity refreshed and relaxed. Single-Pointed Meditation This simple practice of mindful breathing is taught at the BensonHenry Institute for Mind Body Medicine at Massachusetts General Hospital, which is affiliated with Harvard Medical School. It involves silently and gently repeating pairs of words as you breathe in

and out, for instance, in-out, calmease, smile-release and presentmoment. Pairing these positive associations with the breath helps elicit the relaxation response and reduce the stress response. You can use a standard set of six pairs of words and choose the pair you prefer or substitute other words you find most relaxing. What about thinking? The normal mind is a wandering mind. It’s sometimes called the monkey mind, the wild horse mind or the wild elephant mind. You might say the mind has a mind of its own. Thinking is crucial to wise choices and actions, but some thinking can be useless or harmful. Our job in mindfulness practice is to train the mind to pay attention to an intentional object (such as the breath) – training the monkey mind to be our ally, not our master. As you practice mindful breathing, you simply notice the attention has wandered off into thinking, then gently escort the attention back to the breath without any judgment or self-criticism. This gentle return of attention is a crucial part of the practice. Mindful breathing can help you manage stress and improve your overall health and well-being. It can connect you to your inner resource of relaxation and healing – almost anywhere, any time. Even one mindful breath repeated several times a day is good medicine.

watch?v=gAIYm6wpzw4 • Three Minute Breathing Space, guided audio practice from the creators of Mindfulness Based Cognitive Therapy (MBCT) http://franticworld.com/the-threeminute-breathing-space-meditation-is-now-free-to-download/ • I have recorded two mindful breathing practices (5 minutes each) you can access on my web page at www.mindbodystudio. org/?page_id=1594

About the Author: Dr. John Patterson chairs the Lexington Medical Society’s Physician Wellness Commission, is past president of the Kentucky Academy of Family Physicians, is board certified in family medicine and integrative holistic medicine and is a certified Physician Coach. He teaches mindfulness for the UK Health and Wellness Program, Saybrook College of Integrative Medicine and Health Sciences in Pasadena, Calif., and the Center for Mind Body Medicine in Washington, D.C. He owns Mind Body Studio in Lexington, where he offers integrative mind-body medicine consultations and classes, specializing in mindfulness for stress-related chronic conditions and burnout prevention. He can be reached through his Web site at www. mindbodystudio.org.

Resources

• Single Pointed Meditation, guided video practice from Benson-Henry Institute for Mind Body Medicine (6:58) https://www.youtube.com/

The mind has a mind of its own.

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General Dentistry.

GUM PROBLEMS

June 2020

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any people have heard of periodontal or gum disease and they understand those who suffer from it can experience tooth loss if the condition is left unchecked. In fact, periodontal disease is the leading cause of tooth loss, damaging the mouth silently with possibly little to no symptoms such as pain. What some people may not understand is the association between periodontal disease and other systemic, chronic conditions. Periodontal disease is a chronic inflammatory disease. In an effort to fight bacteria in the mouth, the body basically attacks itself. During this attack, tiny spaces or pockets may develop between the teeth and gum line. The creation of these spaces allows tartar (a hard, crusty deposit that must be removed by a dental professional), plaque (a sticky substance created from leftover food particles and saliva) and other bacteria to settle between the gum line and teeth. These pockets can become infected by toxins from bacteria and cause bone loss and additional inflammation that affect other areas of the body.

SYSTEMIC CHRONIC CONDITIONS

Inflammation present in chronic gum disease is thought to be responsible for the documented association between periodontal disease and other systemic chronic conditions. The treatment of periodontal disease may actually help prevent or manage the following systemic chronic conditions: Diabetes It is well documented that people with diabetes are more likely to have periodontal disease. Moreover, studies have shown the relationship between diabetes and periodontal disease is bidirectional, meaning the presence of one condition promotes the presence of the other. Diabetic patients with periodontal disease have difficulty controlling their blood sugar, making diabetic complications more likely to develop at a higher rate. Heart Disease Several studies have shown an association between periodontal disease and heart disease. It is believed the inflammation associated with periodontal disease may be responsible for this association. Periodontal disease may increase the risk of heart disease and may also worsen existing heart conditions. Stroke The association between stroke and periodontal disease has been shown in some clinical studies. Periodontal disease has been linked to a higher rate of strokes caused by the hardening and blockage of large arteries in the brain. Osteoporosis Patients with osteoporosis have a greater tendency to lose bone around the teeth. It has been suggested osteoporosis is a predisposing or influencing factor in the progression of periodontal disease. Respiratory Disease It is believed people with periodontal disease may aspirate or breathe bacteria into their lungs, causing respiratory diseases such as pneumonia. Cancer Clinical studies have shown men with gum disease were 49 percent more likely to develop kidney cancer, 54 percent more likely to develop pancreatic cancer and 30 percent more likely to develop blood cancers.

RISK FACTORS

In addition to following good oral health practices, it is also important to be mindful of other factors that may put individuals at a higher risk of developing gum or periodontal disease. These include: Age Older people are at higher risk of developing periodontal disease. Smoking Numerous studies confirm the relationship between smoking and periodontal disease. Smokers have increased risk and the progression and severity of periodontal disease is substantially higher in smokers compared to non-smokers. Genetics Some individuals may be genetically susceptible to periodontal disease. They are more likely to develop periodontal disease despite aggressive oral care habits. Stress Stress is associated with many serious conditions, including hypertension and cancer. It is also a risk factor for periodontal disease. Research shows stress can make fighting off infection, including periodontal disease, more difficult for the body. Medications Certain medications, such as oral contraceptives, antidepressants and heart medicines, may affect the gums. Obesity Studies show obese individuals are at a higher risk of developing periodontal disease.

HOW CAN A PERIODONTIST HELP

A periodontist is a dentist who has received up to three years of additional training focusing on the treatment of gum disease and replacement of missing teeth with dental implants. A periodontist can perform a thorough clinical and radiographic exam of a patientâ&#x20AC;&#x2122;s mouth to determine if periodontal disease is present or if there is risk of developing the condition. Periodontists have been trained in both surgical and non-surgical methods of disease treatment. Today, there are many advancements in the treatment of periodontal disease, such as the use of minimally invasive procedures and laser treatments. About the Author

Dr. Mohanad Al-Sabbagh is a professor and Chief of Periodontology at the University of Kentucky College of Dentistry. His clinical interests include treatment of periodontal disease with laser, minimally invasive procedures for the treatment of gum recession, cosmetic periodontics and dental implants to replace missing teeth. Dr. Al-Sabbagh sees patients both in the Periodontics Clinic, located in the Dental Science Building at 800 Rose Street in Lexington, as well as UK Dentistry at Turfland, located at 2195 Harrodsburg Road, Suite 175 in Lexington. More information about UK Dentistry is available at www.ukhealthcare.uky.edu/dentistry.

ABOUT UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY Clinic Info: 859-323-DENT (3368) â&#x20AC;˘ ukhealthcare.uky.edu/dentistry UK Dentistry offers expert, personalized care for the general and specialty dental and oral health needs of adults and children. We're committed to improving Kentucky, and beyond, one smile at a time.

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NOT ALL HEROES WEAR CAPES. OUR HEROES WEAR MASKS. Recognize your hero by tagging UK HealthCare and #TeamKentucky so we can see and share. UK HealthCare UK_HealthCare


HELPING YOU STAY HEALTHY AT HOME CONNECT TO OUR PROVIDERS VIRTUALLY WITH A UK TELECARE APPOINTMENT You can feel confident knowing that UK HealthCare is here to care for your medical needs. Through UK TeleCare, we can see you in the safety and comfort of your own home. Using your phone, tablet or computer, you can set up the following types of care: • Urgent care • Primary care • Specialty care • Follow-up care

TWO OPTIONS AVAILABLE UK TeleCare UK TeleCare allows you to continue with regularly scheduled primary and specialty care appointments through a video visit with your provider. To schedule a TeleCare visit, contact the respective clinic directly. ukhealthcare.uky.edu/telecare

UK Urgent TeleCare UK Urgent TeleCare is available for sudden-onset symptoms such as fever, cough, congestion, respiratory difficulties or sore throat. This is similar to visiting an urgent care clinic. To make an Urgent TeleCare appointment, call: 833-739-0225 ukhealthcare.uky.edu/ urgent-telecare


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June 2020 | Read this issue and more at www.healthandwellnessmagazine.com |

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PSYCHOLOGICAL FACTORS

It is important to develop an awareness

FACING PEOPLE WITH DIABETES AND THEIR CAREGIVERS

Caregiving can have many rewards.

of psychological factors inherent in treating individuals with diabetes and their caregivers. These factors are recognized for their relationship to the incidence and progression of type 2 diabetes as a chronic condition.


For advertising information call 859.368.0778 or email brian@rockpointpublishing.com | June 2020

By Dr. Tom Miller Staff Writer There are a number of psychological and emotional challenges individuals with diabetes may face. These concerns may include periods of anxiety and depression; a feeling of helplessness and hopelessness; anger directed inwardly and/ or toward their caregiver’s efforts to help them; a reduced tolerance for necessary medical procedures; and periodic refusal to cooperate with testing procedures and treatment compliance. Emotional shifts can occur as well that can effect one’s memory, self-efficacy and how one manages the stress and tension that often comes with diabetes management. Memory as a risk factor for nonadherence may involve someone unintentionally forgetting to comply with taking medication and other treatment procedures. Selfefficacy is an individual’s belief in their own capacity to effectively manage their medical condition. Some people with diabetes who have an increased level of self-efficacy often have high levels of motivation to manage their diabetes with good compliance for their condition. A person’s level of self-efficacy is critical in successfully managing their diabetes because it increases the assurance the patient accepts

the responsibility to perform needed actions to successfully treat their medical condition. Caregivers are instrumental in providing assistance to a spouse, partner or family member with diabetes. Caregiving can have many rewards. For most caregivers, being there when a loved one needs them is a core value the caregiver wishes to provide. With some people who have diabetes, a shift in roles from partner or friend to caregiver has some tradeoffs. With chronic illness, it is natural for caregivers to feel frustrated at times or exhausted, angry, alone or unappreciated. The emotional and physical stress of caregiving is common. People who experience caregiver stress can be vulnerable to changes in their own health. And with diabetes, both the patient and their caregiver(s) may experience increased stress, anxiety and depression over time because of this chronic condition. The emotional and psychological demands involved in managing one’s diabetes can be eased by setting realistic goals for that management. Break large tasks into smaller steps that can be done one at a time. Prioritize specific tasks, make lists and establish a daily routine. Find out about resources in the community that may be beneficial to both the patient and the caregiver. Many communities have classes

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specifically focusing on different aspects of diabetes care and treatment for both patients and caregivers. Support groups for both can also provide validation and encouragement as well as problem-solving strategies for difficult situations. People in support groups tend to understand what others are experiencing, so this can be a good place to create meaningful friendships. Make an effort to stay well-connected with family members and friends who can offer nonjudgmental emotional support. Establish a good sleep routine. Find time to be physically active most days of the week. Eat a healthy diet and drink plenty of water. Stay in contact with your diabetic educator, specialist and primary care physician and seek mental health care as needed. Understanding and addressing the psychological factors facing people with diabetes and their caregivers can contribute to the adherence and compliance so necessary to live a healthy life despite diabetes. Sources and Resources

• American Diabetes Association (www.diabetes.org) • Centers for Disease Control and Prevention (www.cdc.gov/diabetes)

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Your Family, Your Health, Our Passion Family Practice Associates of Lexington, P.S.C. Proudly serving Kentucky for 35 years.

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Family Doc.

June 2020

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TAKING SAFETY SERIOUSLY

FPA OFFICE IMPLEMENTS PRECAUTIONS IN LIGHT OF THE PANDEMIC

WE ARE USING MOBILE CHECKIN AND OTHER PROTOCOLS, SUCH AS WAITING IN YOUR CAR AFTER CHECK-IN, TO MINIMIZE RISKS. By Dr. Joe Gerhardstein, FAAFP, Family Practice Associates of Lexington, P.S.C.

T

he COVID-19 pandemic has required Family Practice Associates to make some changes to safeguard the health of both our patients and our staff. During this time, certain services may not be offered and our evening hours may not be available. COVID-19 testing can be done at our office, but we have a limited supply of testing kits, so providers will determine if you qualify. In accordance with the governor’s and the health department’s guidelines, FPA providers are now seeing patients in the office for most conditions as well as via telehealth. You can schedule a face-to-face or telehealth visit with one of our providers by calling (859) 278-5007 or sending a message via your patient portal. Most acute illnesses should be seen in the office along with follow-ups for serious and chronic conditions, such as high blood pressure, diabetes and high cholesterol, including performing labs and making refills, as well as doing annual physicals. We want to be sure patients with serious and chronic conditions receive proper evaluations, lab work, etc., so their conditions do not deteriorate. Telehealth options are also available. We are using mobile check-in and other protocols, such as waiting in your car after check-in, to minimize risks. According to published guidelines, all patients coming into the office should wear their own masks and limit to having one accompanying family member only if necessary. FPA is taking extra precautions, including social distancing within our office, cleaning and disinfecting frequently and between patients as well as taking the temperatures of everyone who comes into the office. Our staff will wear masks. Pre-visit emails from Phreesia allow patients to complete all registrations from home. These include screens for COVID-19, including fever, cough, etc. Patients will also receive instructions for next steps. We have implemented online scheduling to make it easier for you to reschedule appointments that were canceled during the pandemic.

Simply go to our Web site at www.fpalex.com and click the Online Scheduling button. Our office at 615 East Brannon Road, Suite 100, reopened May 11 with our usual provider schedule. Counseling services with Raleigh Kincaid, LMFT, and our newest mental health provider, Dr. Latoya Lee, DNP, APRN, are available at our Brannon office and via telehealth. Our physical therapist, Theresa Hobson, PT, is also seeing patients at our Brannon office on the second floor and via telehealth. Our goals are to protect our staff and patients but also to keep patients healthy and out of hospitals and emergency rooms. We are urging all our patients to follow the standard recommendations: practice social distancing, cover your cough, wash your hands frequently, use sanitizer, wear your masks and be kind to others. Please be patient with us as things begin to return to normal. We want everyone to feel comfortable and know they are not at risk when they come to our office. We are doing our best to care for our patients in the safest way possible during this unprecedented crisis. Please call our office at (859) 278-5007 or send a patient portal message if you have any questions or if you need to make an appointment. We also wanted to say thank you to all who have been praying for one of our founding physicians, Dr. Jeffrey Foxx, during his battle with COVID-19. Thankfully, he is feeling better and is recovering at home. If you had an appointment scheduled with Dr. Foxx, please feel free to reschedule with one of our other providers until he returns. Your Family, Your Health, Our Passion. About the Author

Dr. Joe Gerhardstein is a native of Fort Thomas, Ky. He joined Family Practice Associates of Lexington in 2003. Dr. Gerhardstein shares Nietzsche’s philosophy: “That which does not kill us only makes us stronger.”

ABOUT FAMILY PRACTICE ASSOCIATES OF LEXINGTON TWO LOCATIONS: 1775 Alysheba Way, Ste. 201 and 615 East Brannon Road, Ste. 100 • 859.278.5007 • www.fpalex.com Proudly serving Kentucky for over 35 years, Family Practice Associates of Lexington is a group of primary care providers who are dedicated to giving family-centered care from birth to later years.


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For advertising information call 859.368.0778 or email brian@rockpointpublishing.com | June 2020

GOOD AND BAD

SUGARS SOME ARE NATURAL, SOME ARE ADDED – CHOOSE SWEETENERS WISELY By Jamie Lober, Staff Writer All sugars are not the same. Some occur naturally in fruits, vegetables and dairy products. Others are added during processing or preparation. One of the top sources of added sugars in the diet are sugary beverages and sweets. While both natural and added sugar is processed identically by the body, natural sugar is usually digested along with other good nutrients such protein, fiber, phytochemicals, vitamins and minerals and does not have negative effects on your health. Fiber in particular makes a difference because it slows the absorption of sugar and prevents the body from spiking your blood sugar. The American Heart Association (AHA) encourages consumers to read nutrition facts labels and pay close attention when they list natural and added grams of sugar. Keep in mind there are many names for sugar. Many end in ose, such as maltose and sucrose, but other examples include high fructose corn syrup, raw sugar, honey, fruit juice concentrates and cane sugar. The AHA recommends limiting added sugars to no more than half of your daily discretionary calories allowance. The organization further breaks it down by suggesting women consume no more than 100 calories a day, or 6 teaspoons of sugar, and men consume 150 calories a day, or 9 teaspoons. The American Diabetes Association says the U.S. Food and Drug Administration recognizes products that are safe for people with diabetes, such as saccharin, advantame, sucralose, aspartame, neotame and others. These are good alternatives to sugar. The association recommends people look into claims such as sugar-free, reduced sugar or no sugar added and see what the nutrition facts label really says.

There are healthy ways to add a little sugar to a beverage or food. Sugar is a perfect way to add some extra flavor to food such as whole-grain cereal or low-fat yogurt. Other options you may enjoy include fresh or dried fruits or natural juice. If you bake, cut the amount of sugar required in the recipe back by a third to a half. You will find you probably will not even notice the difference. Extracts such as vanilla, orange, lemon or almond can be excellent additions to recipes as well. Sometimes you can switch out sugar with unsweetened applesauce. It can be hard to make a change overnight. If you’re accustomed to sugary drinks such as sweetened teas or sodas, cut back on them slowly. An easy way to do this is to mix half sweetened and half unsweetened while you adjust. Carrying a water bottle can make it easier to drink something that doesn’t contain sugar throughout the day. If you are not fond of the taste (or non-taste) of water, adding a slice of fruit can impart a touch of flavor. A smoothie that contains frozen fruits and/or vegetables is another great option and you can make your own at home. Everyone can make an effort to be more mindful of what they’re eating. When you stay educated about what’s in various products, it becomes easier to ensure you put the best options in your body. What you eat can have a positive impact on your health if you choose wisely.

What you eat can have a positive impact on your health if you choose wisely.

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HandWmagazine

DIABETES CAN AFFECT ORAL HEALTH TAKE CARE OF YOUR MOUTH AND TEETH AND SEE YOUR DENTIST REGULARLY IF YOU HAVE DIABETES

Even the healthiest person has more bacteria living in their mouth than there are people on the planet.


For advertising information call 859.368.0778 or email brian@rockpointpublishing.com | June 2020

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By Angela S. Hoover, Staff Writer Approximately 34.2 million Americans, or 10.5 percent of the population, have diabetes, according to the Diabetes Research Institute Foundation. This figure includes approximately 7.3 million people who are undiagnosed. Diabetes can affect every part of the body, even when it’s being well-managed. Untreated, diabetes can cause serious problems, including taking a toll on the teeth and oral health in general. Even the healthiest person has more bacteria living in their mouth than there are people on the planet. If these bacteria become prolific in the gums, they can cause periodontal disease, a chronic, inflammatory disease that can destroy the gums. People with diabetes are more prone to gum disease, according to the American Dental Association (ADA). Poor management of blood sugar increases the risk for gum problems. Conversely, as with all infections, serious gum disease may make blood sugar rise. This makes diabetes harder to control since it makes the person more susceptible to infections and less able to fight the bacteria invading the gums. It is hard to know which is the cause and which is the effect. High levels of gingival inflammation was found in subjects with type 1 diabetes despite regular dental visits and limited secondary diabetes complications, according to a study published in the journal Diabetes in July 2018. Secondary diabetic complications or microvascular complications include damage to the eyes, leading to blindness; kidneys, leading to renal failure; and nerves, leading to diabetic foot disorders, including severe infections causing amputation and impotence. A more recent study published in February in the journal Diabetes Spectrum found the rates of missing teeth, removable prostheses and periodontal inflammation was high among hospitalized patients with diabetes. Those with diabetes can also experience inflamed gums that lead to bleeding (gingivitis). Another oral symptom that can occur in people with diabetes is dry mouth, which is caused by a lack of saliva. Saliva protects the teeth. Having less saliva poses a higher risk of developing cavities. Dry mouth can also make it difficult to taste food. Diabetes can lead to delayed wound healing throughout the body, including the mouth. And in children with diabetes, the teeth may erupt at an earlier age than is typical, according to the ADA. Regular visits to the dentist are important for everyone and more so for people with diabetes. Research suggests treating gum disease can help improve blood sugar control in patients with diabetes, decreasing the progression of the disease, says the ADA. Good oral hygiene and regular professional deep cleanings by a dentist can help lower HbA1c levels. (This is the average level of blood sugar over the previous three months, which indicates how well diabetes is being managed.) Controlling blood sugar levels will help oral health. This means taking diabetes-related medications as directed, switching to a healthier diet and increasing exercise. Good blood sugar control helps the body fight bacteria or fungal infections in the mouth and relieves dry mouth caused by diabetes. Health care providers should be aware of the oral health risks of patients with diabetes, and dentists should be aware of how their patients are managing their diabetes. SOURCES:

Websites • American Dental Association (www.ada.org) • American Diabetes Association (www.diabetes.com) • Diabetes Research Institute Foundation (www.diabetesresearch.org) • WebMD (www.webmd.com) Journals • Diabetes • Diabetes Spectrum journal

Regular visits to the dentist are important for everyone and more so for people with diabetes.

IMPROVING KENTUCKY AND BEYOND, ONE SMILE AT A TIME. Read our article in this month’s issue to learn how gum disease can impact more than just your oral health.

ukhealthcare.uky.edu/dentistry

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events june JUNE 2020

HOSTING A HEALTHY EVENT IN CENTRAL KY? Share with our readers by e-mailing details to: brian@rockpointpublishing.com

ongoing featured Daily Centered Community Space

Centered Studio at 309 N. Ashland Ave. Suite 180 in Lexington has a community space where we welcome community groups to gather at no cost. Get in touch with Centered to arrange this for your group. 859-721-1841

Mondays Post-partum Support Group with Sarah Wylie Van Meter

Every Monday at 11:00am Attending this group will give birth parents a time and safe place to feel supported and be in community during their postpartum time journeys. Those who join will be in attendance to each other and to themselves as we exchange ways to care for our own bodies, our emotions, our babies, and our partnerships. Babies of all ages and stages are welcome. Come with or without your baby/babies and don’t fret if you arrive late. Donations-based class. Centered Studio, 309 N. Ashland Ave. Suite 180 in Lexington.

Mondays APRIL THRU JUNE

Mindfulness-Based Stress Reduction (MBSR) The “gold standard” mindfulness program worldwide. Relax the body, quiet the mind, open the heart. 8 week course on Mondays 6:00-8:30 PM. Orientation April 6th. Learn to promote resilience, prevent burnout, cultivate

compassion and manage stressrelated chronic conditions. Instructor: John A. Patterson MD, MSPH, FAAFP. Mind Body Studio 517 Southland Drive, Lexington, KY 859-373-0033. Full details at www.mindbodystudio.org/?page_ id=1262. UK Wellness Program offers deep discount for UK employees, retirees and spouses.

Mondays Mindfulness Meditation with Brent Oliver

Every Monday 8:00pm-9:00pm at Centered Studio, 309 N. Ashland Ave. Suite 180 in Lexington. Mindfulness Meditation is a welcoming meditation community open to everyone. We define mindfulness as concentration power, sensory clarity, and equanimity all working together. Donations-based class.

Tuesday/Friday Gentle Community Yoga w/ Lauren Higdon & Terry Fister

Every Tuesday and Friday at 10:30am-11:30am at Centered Studio, 309 N. Ashland Ave. Suite 180 in Lexington. This weekly restorative class integrates gentle yoga, breathing techniques, meditation and wellness tips for all ages and levels of physical condition. Classes may include chair yoga, restorative, yin yoga, tai chi, and more. Perfect for beginners as well as experienced yogis! Donations-based class.

Saturdays

Lexington Farmer’s Market Every Saturday (April – October, 7am-2pm) downtown Lexington, 241 West Main Street, visit the Lexington Farmers’ Market! Browse herbs and spices, honey, beeswax, candles, body care products, organic products, eggs, meats and fresh, seasonal produce. COVID-19 UPDATE: MARKET IS OPEN; PLEASE PRACTICE SOCIAL DISTANCING. For details, please visit www.lexingtonfarmersmarket.com.


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June 2020

N AT U R E ' S

Elderberry FEELING FINE ON ELDERBERRY (WINE) AND MORE By Tanya Tyler, Editor Health&Wellness Elderberry is the dark purple or red berry from the European elder tree. It is used for making jelly or wine, but it also has some medicinal properties that have come down through the generations. It is one of the most commonly used medicinal plants in the world, with evidence showing Native Americas used it to treat infections and Egyptians used it to heal burns, according to Healthline.com. People have used it to combat cold and flu, as well as for constipation. With the flu, elderberry juice syrup seems to relieve symptoms and reduce the length of time the illness lasts, according to WebMd. Dried elderberries are used to treat sciatica, headaches and dental and nerve pain. Elderberry inhibits the growth of bacteria such as Helicobacter pylori. A skin product containing elderberry extract was found to have a sun protection factor of 9.88. If you’re a teen with acne, try an elderberry face wash. While some of these medicinal claims have been called into question and even disproved, others do appear to possess their stated benefits. The European elderberry or black elder grows up to 30 feet and has clusters of small white- or cream-colored flowers known as elderflowers, which are edible. They are sometimes boiled with sugar to make a syrup, infused into tea or eaten in salad. The tart berries must be cooked before eating. Raw elderberries and the bark and leaves of the plant are poisonous. The leaves have been used for pain relief and to reduce swelling, while the bark has historically been used both as a diuretic and laxative. Apparently elderberry can affect the immune system and might help reduce inflammation. It may also have positive effects

B E A U T Y

on cardiovascular health by reducing levels of uric acid in the blood. Elevated uric acid is linked to increased blood pressure and negative effects on heart health. Elderberry has been shown to increase insulin secretion and improve blood sugar levels. Low-calorie elderberries are high in nutrients such as vitamin C. They are full of fiber and a good source of phenolic acids, compounds that are powerful antioxidants that reduce damage caused by oxidative stress in the body. Anthocyanins, which give the fruit its color, are some of the other antioxidants found in elderberries. These impart the fruit’s antiinflammatory properties. Elderberry may even offer some antidepressant properties. However, extracting, heating or juicing the berries can reduce their antioxidant impact. You can find

If you’re a teen with acne, try an elderberry face wash.

elderberry in numerous forms these days, such as liquids, capsules and gummies. Elderberry juice may reduce the level of fat in the blood and decrease cholesterol. One study using human subjects showed no significant reduction in cholesterol, but a study with mice with high cholesterol found a diet including black elderberry reduced the amount of cholesterol in the liver and aorta but not the blood. Further studies are needed, so whether to use elderberry or not is entirely up to you, but be sure to consult with your primary care physician before incorporating it into your diet. Sources and Resources

• Healthline.com (www.healthline.com) • WebMd (www.webmd.com)


For advertising information call 859.368.0778 or email brian@rockpointpublishing.com | June 2020

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Compiled by Angela S. Hoover, Staff Writer

Too Much Salt Weakens the Immune System

Unsold Bread Transformed Into Probiotic Drink in Singapore

A high-salt diet is not only bad for blood pressure, it also weakens the antibacterial immune defense, according to researchers at the University of Bonn in Germany. Mice fed a high-salt diet had more severe bacterial infections. Human volunteers who ate an additional 6 grams of salt per day – the equivalent of two fast-food meals – also showed pronounced immune deficiencies. “We have now been able to prove for the first time that excessive salt intake also significantly weakens an important arm of the immune system,” said Dr. Christian Kurts with the Institute of Experimental Immunology at the University of Bonn. It was an unexpected finding because other studies have pointed in the opposite direction. Infections with certain skin parasites in lab animals heal faster if they consume a high-salt diet. Macrophages (immune cells that attack, eat and digest parasites) are particularly active in the presence of salt. Several physicians concluded sodium chloride has a generally immune-enhancing effect. “Our results show this generalization is not accurate,” said Katarzyna Jobin, lead author of the study. The body keeps salt concentration fairly constant in the blood and in various organs; otherwise, important biological processes would be impaired. The kidneys filter out additional salt and excrete it in the urine. The kidneys have a salt sensor that activates the salt excretion function. “Only through investigations in an entire organism were we able to uncover the complex control circuits that lead from salt intake to this immunodeficiency,” Kurts said. The results were published in the journal Science Translational Medicine on March 25. The U.S. Food and Drug Administration (FDA) and the World Health Organization (WHO) recommend 5 grams (2,300 mg) a day as the maximum amount of salt for adults – about one level teaspoon. Americans consume nearly double that amount, according to the FDA. That high salt intake comes mainly from processed and prepared foods rather than the salt shaker.

In April, a team of food scientists from the National University of Singapore (NUS) came up with a creative solution to bread waste. They formulated a novel fermentation process to upcycle surplus bread into a beverage fortified with gut-friendly microorganisms. The beverage offers at least 1 billion live probiotic cells per serving, the current amount recommended by the International Scientific Association for Probiotics to deliver maximum health benefits. The creamy, sweet, slightly fizzy drink is the only known probiotic bread-based beverage. After testing different types of bread, the team focused on white sandwich bread. They perfected their recipe in nine months. The bread is cut into small pieces and blended with water to create a breadslurry. After this slurry is pasteurized, probiotic bacteria and yeast are added and the mixture is left to ferment for a day. “Most probiotic drinks are dairy-based and unsuitable for people with lactose intolerance. Our bread-based probiotic beverage is nondairy, making it an attractive option for this group of consumers,” said Dr. Toh Mingzhan with the Department of Food Science and Technology at the NUS Faculty of Science. The NUS team filed a patent for their process and is seeking industry partners to commercialize the drink.

The FDA and WHO recommend 5 grams (2,300 mg) a day as the maximum daily amount of salt for adults.

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June 2020

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Microscopy Innovations Open Possibility of Better Diabetes Treatments Recent innovations in microscopy and other fields could help researchers better understand a type of receptor in the body, potentially leading to more effective treatments for type 2 diabetes. Enhanced imaging of molecules involved in blood sugar control may help improve type 2 diabetes treatments in the future. Recent research by investigators from the University of Birmingham in the United Kingdom has used innovative technology to uncover more information about a key molecule, and this new understanding could have applications in the treatment of metabolic diseases. The researchers focused on obtaining better images of the glucagon-like peptide-1 receptor (GLP1R) that is present on specialized cells, called beta cells, of the pancreas and on certain brain cells that produce insulin. GLP1R can help regulate blood sugar by stimulating the specialized cells to produce more insulin. So far, many of GLP1R’s various characteristics and functions have remained unclear because its minute size has made it difficult to image. Now the team from the University of Birmingham and other international institutions have managed to use innovative, sophisticated microscopy to learn more about GLP1R. The researchers used super-resolution microscopy alongside an advanced moleculetracking technique called immunostaining and experiments in mouse models to learn more about GLP1R. They discovered where these receptors are located on cells and how they react to certain signal molecules. This enabled the team to map and present a comprehensive compilation of updated information about GLP1R, including more accurate indications about how to detect the molecules presence. “Our research allows us to visualize this key receptor in much more detail than before,” said senior study author Prof. David Hodson, University of Birmingham. “Think about watching a movie in standard definition vs. 4K. That’s how big the difference is. We believe this breakthrough will give us a much greater understanding of GLP1R distribution and function. While this will not immediately change treatment for patients, it might influence how we design drugs in the future.” The researchers credit their interdisciplinary approach using innovative tools for their breakthrough in visualizing GLP1R. “Our experiments, made possible by combining expertise in chemistry and cell biology, will improve our understanding of GLP1R in the pancreas and the brain,” said co-author Johannes Broichhagen, Ph.D., from the Max Planck Institute for Medical Research in Heidelberg, Germany. “Our new tools have been used in stem cells and in living animals to visualize this important receptor, and we provide the first super-resolution characterization of such molecules.” Their results were published Jan. 24 in the journal Nature Communications.

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N E W S By Angela S. Hoover, Staff Writer

Burying, Burning Garbage Can Send Antibiotic-Resistance Bacteria into the Air

Most municipal solid waste – plastic, food scraps and lawn clippings that aren’t recycled – is buried in landfills or incinerated. New research by the American Chemical Society (ACS) shows when disposed of this way, municipal solid waste can be an important source of antibiotic-resistance bacteria in the air. Residual antibiotics from discarded medications can be found in the waste and some microbes are resistant to those antibiotics, so they can spread resistance genes to other bacteria, allowing them to survive in the presence of these drugs. Scientists had not previously studied whether this waste releases these bacteria and genes into the air for people and animals to breathe. Researchers investigated the bacterial community and associated antibiotic-resistance genes in the municipal solid waste treatment system of Changzhou, a city in eastern China. Air samples collected around a landfill site, a municipal waste incinerator and two transfer stations where garbage is delivered and processed showed higher levels of particulate matter and bacteria, and 16 antibiotic-resistance genes were identified. These genes were much more abundant in air downwind from the facilities, which suggests the municipal waste treatment systems could be a reservoir of antibiotic-resistance genes that can be transmitted to nearby residents who breathe the air, according to the researchers. Their findings were published March 25 in the ACS’ journal Environmental Science & Technology.

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