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Skipping breakfast with type 2 diabetes could cause dangerous spikes in blood glucose levels


Kurt Wood

Skipping breakfast with type 2 diabetes could cause dangerous spikes in blood glucose levels
People with type 2 diabetes who skip breakfastcould trigger blood sugar spikes and impair insulinfunction, according to new research.
The study, conducted by researchers from Tel Aviv University, contributes to a growing body of research that emphasises the importance of breakfast for people with type 2 diabetes.
"Despite the fact that many studies have previously demonstrated the benefits of a high-caloric breakfast for weight loss and to regulate the glucosemetabolism, very little was known regarding the effect of skipping breakfast on glycemic spikes after meals throughout the entire day," said Professor Daniela Jakubowicz.
The study involved 22 participants, each of whom had type 2 diabetes. The average age of the study group was 56.9 years old. Every participant ate the same diet for two days, which consisted of a balanced meal of milk, tuna, bread, and a chocolate bar. On the second day, however, the participants did not eat breakfast.
"We theorised that the omission of breakfast would not be healthy, but it was surprising to see such a high degree of deterioration of glucose metabolism only because the participants did not eat breakfast.
"For type 2 diabetic individuals, the omission of breakfast is associated with a significant increase in all-day blood sugar spikes and of HbA1c, which represents average blood glucose levels over the preceding three months."
The researchers observed huge blood glucose peaks of 14.9 following lunch, and 16.6 after dinner. After an identical lunch and dinner with breakfast on the first day, the participants peaked at 10.7 after lunch, and 11.9 after dinner.
The study argues that including breakfast as part of your daily diet is more important than the specific foods you eat. Following a low-carb diet - or any other diet for that matter - will apparently have little effect on blood glucose levels if breakfast is skipped.
"This means that reducing the amount of starch and sugars in lunch and dinner will have no effect on reducing elevated glucose levels if diabetes individuals also skip breakfast."
The study was unable to explain exactly why skipping breakfast caused blood sugar spikes, but the researchers theorised that pancreatic beta cells "forget" what they are supposed to do if the time gap between meals is too long. It takes the beta cells some time to remember, so insulin responses aren't as effective as they should be for some time. The end result is heightened blood glucose levels.
Another theory is that going without food for so long increases fatty acids in the blood, which makes insulin less effective than it would otherwise be.
"In light of our study, we highly recommend that type 2 diabetics not skip breakfast, because it causes major damage to the beta cell function and leads to high sugar levels, even if they don't overeat at lunch and dinner," said Professor Jakubowicz.
The research did not examine the effects of skipping breakfast on people with type 1 diabetes. This will hopefully be the next step, according to the researchers.

The findings were published in Diabetes Care.

Breakthrough announced in technique of 'editing' DNA to fight off deadly illnesses


           
A revolutionary technique for “editing” the human genome with extreme precision has been used for the first time to “cut and paste” the genes of a key type of immune cell involved in protecting the body against a wide range of diseases, from diabetes to HIV and cancer.
Scientists believe the development could eventually result in a new approach to fighting viral infections and cancerous tumours, by “gene editing” the T-cells of the immune system in the laboratory before putting them back into the patient to protect against ill health.
Medical researchers have been trying for years to perform accurate gene therapy on T-cells circulating in the bloodstream, which are involved in protecting against invasive pathogens and cancer, as well as auto-immune disorders such as type-1 diabetes, where the immune system attacks the body’s own tissues.
However, they have not succeeded until now in cutting out mutations and precisely replacing them with healthy strands of DNA, said Alexander Marson of the University of California, San Francisco, who led the latest research.
Dr Marson and his colleagues used the Crispr (Clustered, Regularly Interspaced, Short Palindromic Repeat) gene-editing technique to cut and splice fragments of DNA within the chromosomes of human T-cells living in a laboratory dish – as “proof of principle” that the process is precise enough for eventual use as a clinical treatment.

“There is increasing interest in manipulating the genome of T-cells, either by correcting mutations or changing the genome to increase the chances of the cells being able to fight off cancer or infections,” Dr Marson said.
“We wanted not only to cut the genome, but to paste in sequences of DNA into the genome of T-cells. We have now been able to cut as well as paste pieces of the genome into human T-cells – for the first time to our knowledge.”
Crispr (pronounced “crisper”) has proved a highly accurate method of identifying precise positions on the DNA molecule and, with the help of an enzyme called Cas9, cutting the double helix strands and replacing exact sections with synthetic, healthy sequences of DNA.
Experiments on animals have shown that Crispr/Cas9 works better than any previous gene-editing technique and offers a realistic alternative to gene therapy on human cells that does not involve viruses or other cumbersome methods of editing and inserting the corrected DNA sequences.
 “Genome editing in human T-cells has been a notable challenge for the field,” Dr Marson said. “So we spent the past year and a half trying to optimise editing in functional T-cells. There are a lot of potential therapeutic applica tions, and we want to make sure we are driving this as hard as we can.”
“It has been really challenging to get Crispr to work in T-cells. This, in our hands, allows us to achieve a new level of efficiency for cutting and repair,” he added.
A key factor in the breakthrough was the use of a technique called “electroporation”, where an electric field is applied across the T-cells in order to open up microscopic pores in the cell that allow the Crispr/Cas9 molecule to enter.
Dr Marson said that although some of the human T-cells did not survive exposure to the electric field in tests, many more recovered completely and around one in five showed they had successfully taken the gene-editing on board – a 20 per cent efficiency rate that is good enough for clinical use.
In the study, published in the journal Proceedings of the National Academy of Sciences, researchers were able to convert the CXCR4 protein on the surface of T-cells so that the genetically-modified cells were no longer prone to attack by the HIV virus.
“This could be a stepping stone to engineering T-cells that are immune to HIV and then putting them back into the body. Potentially we have the power to engineer proteins that are a target for HIV infection,” Dr Marson said.
In another experiment, the researchers used Crispr/Cas9 to remodel a T-cell protein called PD-1, involved in controlling the immune system’s attack on invasive cancer cells. The idea is to generate T-cells from a cancer patient that can be used to keep the disease in check, or even to eradicate tumours completely.
“There’s actually well-trodden ground putting modified T-cells into patients,” Dr Marson said.
“There are companies out there already doing it and figuring out the safety profile, so there’s increasing clinical infrastructure on which we could potentially piggyback as we work out more details of genome editing.”
He added: “There is still some work needed to be done to ensure it is correctly targeted, but I do think this is a powerful tool to add to the arsenal.
“For me, it’s the sort of thing that’s kept me up at night over the past year thinking about the possible clinical applications. It’s a game-changer.”
Jennifer Doudna
There is one scientist whose name constantly crops up in connection with the Crispr-Cas9 gene-editing technology.
A revolutionary technique for “editing” the human genome with extreme precision has been used for the first time to “cut and paste” the genes of a key type of immune cell involved in protecting the body against a wide range of diseases, from diabetes to HIV and cancer.
Scientists believe the development could eventually result in a new approach to fighting viral infections and cancerous tumours, by “gene editing” the T-cells of the immune system in the laboratory before putting them back into the patient to protect against ill health.
Medical researchers have been trying for years to perform accurate gene therapy on T-cells circulating in the bloodstream, which are involved in protecting against invasive pathogens and cancer, as well as auto-immune disorders such as type-1 diabetes, where the immune system attacks the body’s own tissues.
However, they have not succeeded until now in cutting out mutations and precisely replacing them with healthy strands of DNA, said Alexander Marson of the University of California, San Francisco, who led the latest research.
Dr Marson and his colleagues used the Crispr (Clustered, Regularly Interspaced, Short Palindromic Repeat) gene-editing technique to cut and splice fragments of DNA within the chromosomes of human T-cells living in a laboratory dish – as “proof of principle” that the process is precise enough for eventual use as a clinical treatment.
“There is increasing interest in manipulating the genome of T-cells, either by correcting mutations or changing the genome to increase the chances of the cells being able to fight off cancer or infections,” Dr Marson said.
“We wanted not only to cut the genome, but to paste in sequences of DNA into the genome of T-cells. We have now been able to cut as well as paste pieces of the genome into human T-cells – for the first time to our knowledge.”
Crispr (pronounced “crisper”) has proved a highly accurate method of identifying precise positions on the DNA molecule and, with the help of an enzyme called Cas9, cutting the double helix strands and replacing exact sections with synthetic, healthy sequences of DNA.
Experiments on animals have shown that Crispr/Cas9 works better than any previous gene-editing technique and offers a realistic alternative to gene therapy on human cells that does not involve viruses or other cumbersome methods of editing and inserting the corrected DNA sequences.
“Genome editing in human T-cells has been a notable challenge for the field,” Dr Marson said. “So we spent the past year and a half trying to optimise editing in functional T-cells. There are a lot of potential therapeutic applications, and we want to make sure we are driving this as hard as we can.”
“It has been really challenging to get Crispr to work in T-cells. This, in our hands, allows us to achieve a new level of efficiency for cutting and repair,” he added.
A key factor in the breakthrough was the use of a technique called “electroporation”, where an electric field is applied across the T-cells in order to open up microscopic pores in the cell that allow the Crispr/Cas9 molecule to enter.
Dr Marson said that although some of the human T-cells did not survive exposure to the electric field in tests, many more recovered completely and around one in five showed they had successfully taken the gene-editing on board – a 20 per cent efficiency rate that is good enough for clinical use.
In the study, published in the journal Proceedings of the National Academy of Sciences, researchers were able to convert the CXCR4 protein on the surface of T-cells so that the genetically-modified cells were no longer prone to attack by the HIV virus.
“This could be a stepping stone to engineering T-cells that are immune to HIV and then putting them back into the body. Potentially we have the power to engineer proteins that are a target for HIV infection,” Dr Marson said.
In another experiment, the researchers used Crispr/Cas9 to remodel a T-cell protein called PD-1, involved in controlling the immune system’s attack on invasive cancer cells. The idea is to generate T-cells from a cancer patient that can be used to keep the disease in check, or even to eradicate tumours completely.
“There’s actually well-trodden ground putting modified T-cells into patients,” Dr Marson said.
“There are companies out there already doing it and figuring out the safety profile, so there’s increasing clinical infrastructure on which we could potentially piggyback as we work out more details of genome editing.”
He added: “There is still some work needed to be done to ensure it is correctly targeted, but I do think this is a powerful tool to add to the arsenal.
“For me, it’s the sort of thing that’s kept me up at night over the past year thinking about the possible clinical applications. It’s a game-changer.”
There is one scientist whose name constantly crops up in connection with the  Crispr-Cas9 gene-editing technology.
Jennifer Doudna, of the University of California, Berkeley, was not only involved with the latest study, demonstrating how the technique can be used to “cut and paste” the DNA of human T-cells, but was also part of the project that first married the “guide molecule” Crispr with bacterial enzyme Cas-9, creating a powerful gene-editing tool.

“It’s been great to be part of this exciting collaboration, and I look forward to seeing the insights from this work used to help patients in the future,” Professor Doudna said on her contribution to the latest research effort.

Coffee may lower inflammation and reduce risk of diabetes



By Dr. David B. Samadi
FoxNews.com


New research finds drinking coffee may lower inflammation and reduce the risk of developing diabetes.
The study, published in the European Journal of Clinical Nutrition, found that people who drank coffee were about 50 percent less likely to develop type 2 diabetes compared to people who did not drink coffee. Scientists believe that the reason for a reduction in the risk for type 2 diabetes could be the effect coffee has on the reducing the amount of inflammation in the body.
There have been prior studies that have shown a link between coffee consumption and diabetes. This study is unique in that it may help confirm a cause-and-effect hypothesis regarding coffee consumption and diabetes. The study was also different in that the researchers did not randomly assign any of the study participants to drink coffee or not drink coffee, but rather observed them in their coffee drinking habits. This limits any confirmation that coffee consumption prevents diabetes.
The study was initially carried out in 2001 and 2002. The researchers recruited a random sample of more than 1,300 men and women ages 18 years and older from Athens. They were given questionnaires to complete regarding their diet which included questions about how often they drank coffee. Among the participants, there were 816 casual drinkers, 385 habitual drinkers and 239 non-coffee drinkers. Casual drinkers were defined as drinking less than 1.5 cups of coffee a day, while habitual drinkers were defined as drinking more than 1.5 cups a day.
The levels of protein markers of inflammation were also analyzed by taking blood tests from study participants. The blood tests measured levels of antioxidants in the body, which can determine the body’s ability to neutralize cell-damaging free radicals.
The researchers followed up with the study participants ten years later. After ten years, there were 191 people among the original 1,300 people (13 percent of the men and 12 percent of the women) who had developed diabetes. Those who reported drinking more coffee were less likely to develop diabetes.
Among the coffee drinkers who were considered habitual coffee drinkers, 54 percent of them were less likely to develop diabetes compared to those who didn’t drink coffee. This was true even after researchers took into account lifestyle habits or medical history, such as family history of diabetes, smoking, high blood pressure, or drinking other caffeinated beverages.
The researchers noted that the levels of serum amyloid may explain the link between coffee and diabetes. Serum amyloid is an inflammatory marker found in the blood, and what they found was that drinking more coffee was associated with lower levels of serum amyloid.
The researchers concluded that they cannot confirm whether drinking more coffee actually prevents diabetes, but they are one step closer to proving a cause-and-effect relationship. For now, physical exercise and maintaining a healthy body weight is the most effective way to reduce your risk for diabetes.

Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital and professor of urology at Hofstra North Shore-LIJ School of Medicine. He is a medical correspondent for the Fox News Channel's Medical A-Team and the chief medical correspondent for am970 in New York City. Learn more at roboticoncology.com. Visit Dr. Samadi’s blog at SamadiMD.com. Follow Dr. Samadi on Twitter andFacebook.

Study: Type 2 Diabetes Reduces Brain Function Within Just Two Years


A new study published in the journal Neurology shows that Type 2 diabetes triggers a significant reduction in cognitive ability within just a two-year period. The main culprits appear to be increased tissue inflammation and decreased blood flow to the brain.
Researchers conducted several tests on 65 participants (average age 66) at the beginning of a two-year study, roughly half of whom had already been diagnosed with Type 2 diabetes. All of the participants took tests to assess cognitive function and memory performance, and underwent MRI scans and blood tests to measure blood flow and pressure, rate of tissue inflammation, and brain volume.
The tests were repeated after two years, with the following results:
Thinking and memory test scores for participants with Type 2 diabetes dropped 12% over the two-year period. Test scores for participants without diabetes remained steady.
Participants with Type 2 diabetes experienced a 65% decrease in blow flow regulation.
The diabetic participants also experienced a 50% decline in “vasoreactivity” – the ability of blood vessels to contract in response to stimuli, a key indicator of blood vessel health.
“People with type 2 diabetes have impaired blood flow regulation,” according to study co-author Vera Novak, MD, PhD, of Beth Israel Deaconess Medical Center in Boston. “Our results suggest that diabetes and high blood sugar impose a chronic negative effect on cognitive and decision-making skills.”
Negative effects of diabetes on blood flow and blood vessel function are well-evidenced in prior research, but this study added the dimension of linking these effects to changes in brain function over a brief window of time.
“These correlations provided the link between altered cerebral vasoregulation and cognitive deterioration in participants with type 2 diabetes that can be tracked prospectively even over a relatively short time period of 2 years,” according to the research team.
Although this was a small study that should be validated with larger groups of participants, the results further substantiate a link between diabetes and cognitive impairment. Previous studies have found a similar link, including a potential link between diabetes and Alzheimer’s disease.
“Early detection and monitoring of blood flow regulation may be an important predictor of accelerated changes in cognitive and decision-making skills,” Novak said in a statement.
The study was published in the journal Neurology.
For more information about the effects of inflammation on brain function, read this interview with Dr. Barry Sears, creator of the Zone diet.


You can find David DiSalvo on Twitter @neuronarrative and at his website daviddisalvo.org.



Diabetics Have a New Reason to Love Lentils


13/07/2015 21:43:00

U of G research shows lentils reduce the spike in blood sugar following a meal
Feature by Stacey Morrison
Story by Portia Kalun, a U of G student writer with SPARK (Students Promoting Awareness of Research Knowledge)
Diabetics and others concerned about spikes in their blood sugar levels have a new reason to love lentils.
University of Guelph and Guelph Food Research Centre scientists investigating the effects of Canadian-grown lentils on blood sugar levels in healthy adults are finding that lentils reduce the spike in blood sugar following a meal.
“For someone with impaired glucose tolerance, such as a person at risk for diabetes or someone affected by diabetes, that’s really important,” says Dan Ramdath of the Guelph Food Research Centre, who is conducting the research with Prof. Alison Duncan, Human Health and Nutritional Sciences.
Consuming carbohydrate-rich foods, such as white bread or white rice, causes a spike in blood sugar when the carbohydrates are broken down. To remove the sugar from the blood, the body releases insulin. Too many large spikes in glucose and then insulin can increase risk of type 2 diabetes — cells stop responding to consistently high levels of insulin, so sugar from the blood is not removed as efficiently, resulting in type 2 diabetes.

But for reasons still not fully understood by researchers, lentils don’t cause that same spike. Including lentils in one’s diet could attenuate the increase in blood sugar following meals and would not require as much insulin, reducing the risk for type 2 diabetes. Lentil consumption would also be beneficial for those who are already diabetic, as they are more resistant to the effects of insulin.


Big diabetes study tests whether insulin in pills could prevent the disease



By LINDSEY TANNER, AP Medical Writer

CHICAGO (AP) — For nearly a century, insulin has been a life-saving diabetes treatment. Now scientists are testing a tantalizing question: What if pills containing the same medicine patients inject every day could also prevent the disease?
Thirteen-year-old Hayden Murphy of Plainfield, Illinois, is helping researchers determine if the strategy works for Type 1 diabetes, the kind that is usually diagnosed in childhood. If it does, he might be able to avoid the lifetime burdens facing his 5-year-old brother, Weston. They includes countless finger pricks and blood sugar checks, and avoiding playing too hard or eating too little, which both can cause dangerous blood sugar fluctuations.
Hayden Murphy is among more than 400 children and adults participating in U.S. government-funded international research investigating whether experimental insulin capsules can prevent or at least delay Type 1 diabetes. Hospitals in the United States and eight other countries are involved and recruitment is ongoing. To enroll, participants must first get bad news: results of a blood test showing their chances for developing the disease are high.
"When I got the news, I was devastated," Hayden said. He knows it means his life could change in an instant.
"He has the daily reminders. He sees what his brother goes through," said the boys' mom, Myra Murphy.
So now Hayden Murphy swallows a small white capsule daily and has his blood checked periodically for signs of diabetes.
"I hope it doesn't come to me, and I really didn't want it to come to him," Hayden said.
A small, preliminary study by different researchers, published recently in the Journal of the American Medical Association, suggests the approach might work. Children who took insulin pills showed immune system changes that the researchers said might help prevent diabetes. The study was too small and didn't last long enough to know for sure.
The ongoing larger study is more rigorous, randomly assigning participants to get experimental insulin capsules or dummy pills, and should provide a clearer answer.
"Does it prevent indefinitely? Does it slow it down, does it delay diabetes? That also would be a pretty big win," said Dr. Louis Philipson, a University of Chicago diabetes specialist involved in the study.
About 1.25 million Americans have Type 1 diabetes. Type 2 disease is more common, affecting nearly 30 million nationwide and most of the more than 300 million worldwide with diabetes. Besides short-term complications from poorly controlled blood sugar, both types raise long-term risks for damage to the kidneys, heart and eyes.
Both types are increasing and for Type 2, experts think that's because of rising obesity and inactivity. But the upward trend in Type 1 diabetes, increasing worldwide by at least 3 percent each year, is more perplexing.
"We know so very little about the exact mechanisms that cause Type 1 diabetes," which complicates efforts to prevent it, said Dr. Desmond Schatz, the study's chair and medical director of the University of Florida Diabetes Center.
"For the most part, it's really shooting an arrow into a field and hoping one of the arrows hits a target," Schatz said.
In Type 1 diabetes, the pancreas stops making insulin, a blood sugar-regulating hormone that helps the body convert sugar in food into energy. Treatment is lifetime replacement insulin, usually via injections or a small pump. In Type 2, the body can't make proper use of insulin. It can sometimes be treated with a healthy diet and exercise.
Genes are thought to increase risks for Type 1 diabetes. Viruses and other infections are among factors suggested as possible triggers the disease, which causes the body's immune system to attack insulin-producing cells.


Fat, sugar cause bacterial changes that may relate to loss of cognitive function


Donuts are often high in fat and sugar. Experiments with mice show that after just four weeks on a high-fat or a high-sugar diet, the performance of mice on various tests of mental and physical function began to drop, compared to animals on a normal diet. One of the most pronounced changes was in what researchers call cognitive flexibility.
A study at Oregon State University indicates that both a high-fat and a high-sugar diet, compared to a normal diet, cause changes in gut bacteria that appear related to a significant loss of "cognitive flexibility," or the power to adapt and adjust to changing situations.
This effect was most serious on the high-sugar diet, which also showed an impairment of early learning for both long-term and short-term memory.
The findings are consistent with some other studies about the impact of fat and sugar on cognitive function and behavior, and suggest that some of these problems may be linked to alteration of the microbiome -- a complex mixture in the digestive system of about 100 trillion microorganisms.
The research was done with laboratory mice that consumed different diets and then faced a variety of tests, such as water maze testing, to monitor changes in their mental and physical function, and associated impacts on various types of bacteria. The findings were published in the journal Neuroscience, in work supported by the Microbiology Foundation and the National Science Foundation.
"It's increasingly clear that our gut bacteria, or microbiota, can communicate with the human brain," said Kathy Magnusson, a professor in the OSU College of Veterinary Medicine and principal investigator with the Linus Pauling Institute.
"Bacteria can release compounds that act as neurotransmitters, stimulate sensory nerves or the immune system, and affect a wide range of biological functions," she said. "We're not sure just what messages are being sent, but we are tracking down the pathways and the effects."
Mice have proven to be a particularly good model for studies relevant to humans, Magnusson said, on such topics as aging, spatial memory, obesity and other issues.
In this research, after just four weeks on a high-fat or a high-sugar diet, the performance of mice on various tests of mental and physical function began to drop, compared to animals on a normal diet. One of the most pronounced changes was in what researchers call cognitive flexibility.
"The impairment of cognitive flexibility in this study was pretty strong," Magnusson said. "Think about driving home on a route that's very familiar to you, something you're used to doing. Then one day that road is closed and you suddenly have to find a new way home."
A person with high levels of cognitive flexibility would immediately adapt to the change, determine the next best route home, and remember to use the same route the following morning, all with little problem. With impaired flexibility, it might be a long, slow, and stressful way home.
This study was done with young animals, Magnusson said, which ordinarily would have a healthier biological system that's better able to resist pathological influences from their microbiota. The findings might be even more pronounced with older animals or humans with compromised intestinal systems, she said.
What's often referred to as the "Western diet," or foods that are high in fat, sugars and simple carbohydrates, has been linked to a range of chronic illnesses in the United States, including the obesity epidemic and an increased incidence of Alzheimer's disease.
"We've known for a while that too much fat and sugar are not good for you," Magnusson said. "This work suggests that fat and sugar are altering your healthy bacterial systems, and that's one of the reasons those foods aren't good for you. It's not just the food that could be influencing your brain, but an interaction between the food and microbial changes."



Life expectancy substantially lower with combination of diabetes, stroke or heart attack


In an analysis that included nearly 1.2 million participants and more than 135,000 deaths, mortality associated with a history of diabetes, stroke, or heart attack was similar for each condition, and the risk of death increased substantially with each additional condition a patient had, according to a study in the July 7 issue of JAMA.
The prevalence of cardiometabolic multimorbidity (defined in this study as a history of 2 or more of the following: diabetes mellitus, stroke, myocardial infarction [MI; heart attack]) is increasing rapidly. Considerable evidence exists about the mortality risk of having any 1 of these conditions alone. However, evidence is sparse about life expectancy among people who have 2 or 3 cardiometabolic conditions at the same time, according to background information in the article.
John Danesh, F.Med.Sci., of the University of Cambridge, England, and colleagues estimated reductions in life expectancy associated with cardiometabolic multimorbidity. Age- and sex-adjusted mortality rates and hazard ratios (HR) were calculated using individual participant data from the Emerging Risk Factors Collaboration (689,300 participants; 91 cohorts; years of baseline surveys: 1960-2007; latest mortality follow-up: April 2013; 128,843 deaths). The hazard ratios from this study population were compared with those from the UK Biobank (499,808 participants; years of baseline surveys: 2006-2010; latest mortality follow-up: November 2013; 7,995 deaths).
Among the primary findings:
•           Compared to participants who did not have a history of any of these conditions (diabetes mellitus, stroke, heart attack), participants who had 1 condition had about twice the rate of death; 2 conditions, about 4 times the rate of death; and all 3 conditions, about 8 times the rate of death. "Our results emphasize the importance of measures to prevent cardiovascular disease in people who already have diabetes, and, conversely, to avert diabetes in people who already have cardiovascular disease," the authors write.
•           The results suggest that estimated reductions in life expectancy associated with cardiometabolic multimorbidity are of similar magnitude to those previously noted for exposures of major concern to public health, such as lifelong smoking (10 years of reduced life expectancy) and infection with the human immunodeficiency virus (11 years of reduced life expectancy). For example, at the age of 60 years, a history of any 2 of these conditions was associated with 12 years of reduced life expectancy and a history of all 3 of these conditions was associated with 15 years of reduced life expectancy. The researchers estimated even greater reductions in life expectancy in patients with multimorbidity at younger ages, such as 23 years of life lost in patients with 3 conditions at the age of 40 years.
•           Modification by sex of associations between cardiometabolic multimorbidity and mortality were noted. For men, the association between baseline cardiovascular disease (i.e., a history of stroke or MI) and reduced survival was stronger than for women, whereas the association between baseline diabetes and reduced survival was stronger for women. Consequently, about 60 percent of the years of life lost from cardiometabolic multimorbidity can be attributed to cardiovascular deaths for men compared with only about 45 percent for women. "Nevertheless, for both men and women, our findings indicate that associations of cardiometabolic multimorbidity extend beyond cardiovascular mortality. Future work will seek to elucidate explanations for these interactions by sex."
The authors write that their results highlight the need to balance the primary prevention and secondary prevention of cardiovascular disease. "About 1 percent of the participants in the cohorts we studied had cardiometabolic multimorbidity compared with an estimate of 3 percent from recent surveys in the United States. There are currently an estimated 10 million adults in the United States and the European Union with cardiometabolic multimorbidity. Nevertheless, an overemphasis on the substantial reductions in life expectancy estimated for the subpopulation with multimorbidity could divert attention and resources away from population-wide strategies that aim to improve health for the large majority of the population."


Childhood stress fuels weight gain in women


When it comes to weight gain for women, childhood stress appears to be a bigger culprit than stress during adulthood, finds a national study led by a Michigan State University sociologist.
Interestingly, though, neither childhood nor adult stress was associated with weight gain for men.
The federally funded study, which appears online in the journal Social Science & Medicine, is the first to examine such lifelong consequences of stress on weight change.
"These findings add to our understanding of how childhood stress is a more important driver of long-term weight gain than adult stress, and how such processes differ for men and women," said Hui Liu, MSU associate professor of sociology and an expert in statistics, population-based health and family science.
Liu and her longtime collaborator, Debra Umberson from the University of Texas, analyzed the data from the Americans' Changing Lives, a national survey in which participants were interviewed four times in a 15-year period. The study encompassed 3,617 people (2,259 women and 1,358 men).
Childhood stress was measured on a range of family-related stressors that occurred at age 16 or younger such as economic hardship, divorce, at least one parent with mental health problem and never knowing one's father. Adult stress included such factors as job loss, death of a significant other and parental and care-provider stress.
Liu said women who experienced higher levels of childhood stress gained weight more rapidly than women who experienced less childhood stress. Change in body mass is a process that unfolds throughout life, she noted, and childhood may be a critical period for establishing patterns that have a long-term impact on women's weight over time.
As far as stress not significantly affecting men's weight, Liu said men and women respond to stress differently.
It may be that women eat more to cope with stress, whereas men are more likely to engage in less weight-related strategies such as withdrawing or drinking alcohol, she said. Gender differences in depression may also help explain the difference. Depression is associated with emotion-driven eating and weight gain, and females are more likely than males to be depressed after adolescence.
The findings highlight the need for treatment and policies designed to reduce stress in childhood.
"Given the importance of body mass on health and disability," Liu said, "it's important that we consider the sex-specific social contexts of early childhood in order to design effective clinical programs that prevent or treat obesity later in life."


Reusable shopping bags encourage shoppers to buy produce -- and junk food?


Bringing reusable bags to the grocery store often means you are an environmentally friendly shopper. But it also influences the very things you buy. According to a new study, bringing your own bags makes you more likely to purchase organic food -- and junk food as well.
________________________________________
Bringing reusable bags to the grocery store often means you are an environmentally friendly shopper. But it also influences the very things you buy. According to a new study in the Journal of Marketing, bringing your own bags makes you more likely to purchase organic food--and junk food as well.
"Grocery store shoppers who bring their own bags are more likely to purchase organic produce and other healthy food. But those same shoppers often feel virtuous, because they are acting in an environmentally responsible way. That feeling easily persuades them that, because they are being good to the environment, they should treat themselves to cookies or potato chips or some other product with lots of fat, salt, or sugar," write the authors, Uma R. Karmarkar (Harvard University) and Bryan Bollinger (Duke University).
The study is one of the first to demonstrate that bringing one's own grocery bags causes significant changes in food purchasing behavior. The authors collected loyalty cardholder data from a single location of a major grocery chain in California between May 2005 and March 2007. They compared the same shoppers on trips for which they brought their own bags with trips for which they did not. Participants were also recruited online from a national pool and were randomly assigned one of two situations: bringing their own bags or not bringing their own bags. Depending on the situation, participants were presented with a certain scenario and a floorplan of the grocery store and were asked to list the ten items they were most likely to purchase on the trip.
The researchers found that when shoppers brought their own bags, they were more likely to purchase organic foods. At the same time, bringing one's own bags also increased the likelihood that the shopper would purchase junk food. And both results were slightly less likely when the shopper had young children: parents have to balance their own purchasing preferences with competing motivations arising from their role as parents.

"In short, bringing your own bags changes the way you shop," write the authors. "Our findings thus have important implications for grocery store managers. In stores where reusable bags are popular, marketing organic or sustainably farmed foods as indulgences could increase the sales of those items."

If food companies won't act responsibly, lets tax their products until they do.


Lawmakers propose soda tax to avoid raising income, property taxes
WIAT staff Published: July 6, 2015
WIAT) – If you’ve needed a reason to cut back on soft drinks, you may soon have a new one. Alabama lawmakers are hoping to cash in on the popularity of sodas by adding a new five cent tax on every 12 ounces of soft drinks you buy.
Governor Bentley is calling this proposed tax hike on sodas part of his plan to add “user taxes.”
These will help him avoid raising income and property taxes.
Alabama lawmakers have not agreed with the governor on a plan to address the states $200 million budget shortfall.
WIAT asked people on the street what they thought of the soda tax.
“It wouldn’t affect us, if it was just five cents more and we bought a soda there,” Abby Rensink said.
WIAT talked to a man who said, “I would like to see where it’s going, the tax would affect the poor a lot more than people with money.”
Alabama already has a four percent tax on soda.
Legislators are expected to continue working in special sessions until a new budget is passed.



Vermont Soda Tax Goes into Effect
 In addition to 6% tax on sodas, vending machine purchases now taxed at 9%.
July 7, 2015
BURLINGTON – Beginning July 1, Vermont residents can expect to pay more when they get the urge to snack, with the introduction of a new 6% sales tax on soft drinks and a 9% meals tax on vending machine items.
The taxes are part of a $30 million package of tax increases that took effect this month, intended to help close a total $113 million gap between projected state spending and revenue. The sales tax on soft drinks is estimated to generate $7.9 million in revenue, while extending the meals tax to vending machines is estimated to yield $1 million.
One controversial aspect of the new law is that customers who use food stamps are exempt from the sales tax on soft drinks. Many are saying that those consumers who use food stamps now have no incentive to make healthier choices and goes against the initial intention of soft drink tax, which was to discourage consumption of unhealthy products.
The vending machine tax applies only to items sold in the machines, not to those same items if purchased elsewhere, such as a grocery store. According to local news reports, the tax department has been conducting outreach to notify businesses about the new taxes, but word had failed to reach everyone in time.
The Vermont Retailers and Grocers Association has also played a leading role in notifying businesses of their obligation to collect the new taxes, inviting members to participate in webinars on the tax change. A guide to the Vermont sales tax on soft drinks is available at http://bit.ly/vtdrinktaxes.





Perceived Discrimination: Influencing Behavior in Diabetics


Jeannette Y. Wick, RPh, MBA, FASCP

  Approximately 13.2 % of adults who have type 2 diabetes mellitus (T2DM) are non-Hispanic blacks. Compared to others, people from ethnic minorities tend to have higher prevalence, risk of complications, and mortality related to T2DM. Racial disparities in health care are well documented. Researchers from the Medical University of South Carolina recently asked the question, “Is perceived discrimination a stressor for patients who have T2DM?” Their study, published in the June 2015 issue of Endocrine Practice, indicates that perceived discrimination influences health behavior.
 Using a large sample size of black and white patients with T2DM (N=602 adults), the researchers queried perceived racial discrimination and measured glycemic control, blood pressure, and LDL cholesterol. They also examined health behaviors known to improve diabetes outcomes. They looked at diet in two ways: (1) general diet, or ability to follow a healthy diet, and (2) specific diet, or consumption of fruits and fat.
 All patients received care at adult primary care clinics in either a local Veterans Administration medical center or an academic medical center in the southeastern United States.
 Patients’ average age was 61 years. Almost 65% identified as non-Hispanic black, and 41.6 % reported incomes of less than $20,000 annually.
 Perceived discrimination significantly reduced the mental component of quality of life. In addition, patients who had perceived discrimination had poorer and specific general diets.
 Non-Hispanic black patients who reported perceived discrimination were significantly more likely to have higher systolic blood pressure.
 Whites who had perceived discrimination were also more likely to have general and specific diet deficits, and they were less likely to adhere to blood glucose testing recommendations.
 Patients reporting income between $10,000 and $14,999 seemed to be disproportionately (negatively) affected.
 The researchers urge clinicians to tailor diabetes education programs to reflect patients’ cultures and consider psychosocial factors including perceived discrimination.



Quotes from “No time to say goodbye: memoirs of a life in foster care” by John William Tuohy.



On sale now at Amazon.Com, Border Books and direct from LLR Books.Com
http://www.amazon.com/No-Time-Say-Goodbye-Memoir/dp/

********************
In 1962, six year old John Tuohy, his two brothers and two sisters entered Connecticut’s foster care system and were promptly split apart. Over the next ten years, John would live in more than ten foster homes, group homes and state schools, from his native Waterbury to Ansonia, New Haven, West Haven, Deep River and Hartford. In the end, a decade later, the state returned him to the same home and the same parents they had taken him from. As tragic as is funny compelling story will make you cry and laugh as you journey with this child to overcome the obstacles of the foster care system and find his dreams.
http://www.amazon.com/No-Time-Say-Goodbye-Memoir/dp/0692361294/
http://amemoirofalifeinfostercare.blogspot.com/

ABOUT THE AUTHOR
John William Tuohy is a writer who lives in Washington DC. He holds an MFA in writing from Lindenwood University. He is the author of numerous non-fiction on the history of organized crime including the ground break biography of bootlegger Roger Tuohy "When Capone's Mob Murdered Touhy" and "Guns and Glamour: A History of Organized Crime in Chicago."
His non-fiction crime short stories have appeared in The New Criminologist, American Mafia and other publications. John won the City of Chicago's Celtic Playfest for his work The Hannigan's of Beverly, and his short story fiction work, Karma Finds Franny Glass, appeared in AdmitTwo Magazine in October of 2008.
His play, Cyberdate.Com, was chosen for a public performance at the Actors Chapel in Manhattan in February of 2007 as part of the groups Reading Series for New York project. In June of 2008, the play won the Virginia Theater of The First Amendment Award for best new play.


Contact John:
MYWRITERSSITE.BLOGSPOT.COM
JWTUOHY95@GMAIL.COM


From Professor William Anthony Connolly

This incredible memoir, No Time to Say Goodbye, tells of entertaining angels, dancing with devils, and of the abandoned children many viewed simply as raining manna from some lesser god.
The young and unfortunate lives of the Tuohy bruins—sometimes Irish, sometimes Jewish, often Catholic, rambunctious, but all imbued with Lion’s hearts— is told here with brutal honesty leavened with humor and laudable introspective forgiveness.
The memoir will have you falling to your knees thanking that benevolent Irish cop in the sky, your lucky stars, or hugging the oxygen out of your own kids the fate foisted upon Johnny and his siblings does not and did not befall your own brood.
 John William Tuohy, a nationally-recognized authority on organized crime and Irish levity, is your trusted guide through the weeds the decades of neglect ensnared he and his brothers and sisters, all suffering for the impersonal and often mercenary taint of the foster care system.
Theirs, and Tuohy’s, story is not at all figures of speech as this review might suggest, but all too real and all too sad, and maddening. I wanted to scream. I wanted to get into a time machine, go back and adopt every last one of them. I was angry. I was captivated.
The requisite damning verities of foster care are all here, regretfully, but what sets this story above others is its beating heart, even a bruised and broken one, still willing to forgive and understand, and continue to aid its walking wounded. I cannot recommend this book enough

 “I am here because I worked too hard and too long not to be here. But although I told the university that I would walk across the stage to take my diploma, I won’t. At age fifty-seven, I’m too damned old, and I’d look ridiculous in this crowd. From where I’m standing in the back of the hall, I can see that I am at least two decades older than most of the parents of these kids in their black caps and gowns.
So I’ll graduate with this class, but I won’t walk across the stage and collect my diploma with them; I’ll have the school send it to my house. I only want to hear my name called. I’ll imagine what the rest would have been like. When you’ve had a life like mine, you learn to do that, to imagine the good things.
The ceremony is about to begin. It’s a warm June day and a hallway of glass doors leading to the parking lot are open, the dignitaries march onto the stage, a janitor slams the doors shut, one after the other.
That banging sound.
It’s Christmas Day 1961 and three Waterbury cops are throwing their bulk against our sorely overmatched front door. They are wearing their long woolen blue coats and white gloves and they swear at the cold.
They’ve finally come for us, in the dead of night, to take us away, just as our mother said they would.”
********************
 
“Otherwise, there were no long goodbyes or emotional scenes. That isn’t part of foster care. You just leave and you just die a little bit. Just a little bit because a little bit more of you understands that this is the way it’s going to be. And you grow hard around the edges, just a little bit. Not in some big way, but just a little bit because you have to, because if you don’t it only hurts worse the next time and a little bit more of you will die. And you don’t want that because you know that if enough little bits of you die enough times, a part of you leaves. Do you know what I mean? You’re still there, but a part of you leaves until you stand on the sidelines of life, simply watching, like a ghost that everyone can see and no one is bothered by. You become the saddest thing there is: a child of God who has given .”

  ********************

“As I said, you die a little bit in foster care, but I spose we all die a little bit in our daily lives, no matter what path God has chosen for us. But there is always a balance to that sadness; there’s always a balance. You only have to look for it. And if you look for it, you’ll see it. I saw it in a well-meaning nun who wanted to share the joy of her life’s work with us. I saw it in an old man in a garden who shared the beauty of the soil and the joy he took in art, and I saw it in the simple decency and kindness of an underpaid nurse’s aide. Yeah. Great things rain  on us. The magnificence of life’s affirmations are all around us, every day, everywhere. They usually go unnoticed because they seldom arrive with the drama and heartbreak of those hundreds of negative things that drain our souls. But yeah, it’s there, the good stuff, the stuff worth living for. You only have to look for it and when you see it, carry it around right there at the of your heart so it’s always there when you need it. And you’ll need it a lot, because life is hard.”
  ********************
“As sad as I so often was, and I was often overwhelmed with sadness, I never admitted it, and I don’t recall ever having said aloud that I was sad. I tried not to think about it, about all the sad things, because I had this feeling that if I started to think about it, that was all I would ever think of again. I often had a nightmare of falling  into a deep dark well that I could never climb out of. But then there was the other part of me that honestly believed I wasn’t sad at all, and I had little compassion for those who dwelled in sadness. Strange how that works. You would think that it would be the other way around.”

********************

 “In late October of 1962, it was our turn to go. Miss Hanrahan appeared in her state Ford Rambler, which, by that point, seemed more like a hearse than a nice lady’s car. Our belongings were packed in a brown bags. The ladies in the kitchen, familiar with our love of food, made us twelve fried-fish sandwiches each large enough to feed eight grown men and wrapped them in tinfoil for the ride ahead of us. Miss Louisa, drenched with tears, walked us to the car and before she let go of my hand she said, “When you a big, grown man, you come back and see Miss Louisa, you hear?”
“But,” I said, “you won’t know who I am. I’ll be big.”
“No, child,” she said as she gave me her last hug, “you always know forever the peoples you love. They with you forever. They don’t never leave you.”
She was right, of course. Those we love never leave us because we carry them with us in our hearts and a piece of us is within them. They change with us and they grow old with us and with time, they are a part of us, and thank God for that.”

********************

 “One day at the library I found a stack of record albums. I was hoping I’d find ta Beatles album, but it was all classical music so I reached for the first name I knew, Beethoven. I checked it out his Sixth Symphony and walked home. I didn’t own a record player and I don’t know why I took it out. I had Beethoven’s Sixth Symphony but nothing to play it on.”

********************

 “The next day, when I came home from the library, there was a small, used red record player in my room. I found my mother in the kitchen and spotted a bandage taped to her arm.
“Ma,” I asked. “Where did you get the money for the record player?”
“I had it saved,” she lied.
My father lived well, had a large house and an expensive imported car, wanted for little, and gave nothing. My mother lived on welfare in a slum and sold her blood to the Red Cross to get me a record player.
“Education is everything, Johnny,” she said, as she headed for the refrigerator to get me food. “You get smart like regular people and you don’t have to live like this no more.”
She and I were not hugging types, but I put my hand on her shoulder as she washed the dishes with her back to me and she said, in best Brooklynese, “So go and enjoy, already.” My father always said I was my mother’s son and I was proud of that. On her good days, she was a good and noble thing to be a part of.
That evening, I plugged in the red record player and placed it by the window. My mother and I took the kitchen chairs out to the porch and listened to Beethoven’s Sixth Symphony from beginning to end, as we watched the oil-stained waters of the Mad River roll by. It was a good night, another good night, one of many that have blessed my life.”

********************

“The next day I was driven to New York City to take the physical. It was one of the strangest things I’d ever seen. Several hundred young men, maybe even a thousand, in their skivvies, walking around an enormous room, all of us lost, dazed, and confused.
Some of these guys had dodged the draft and were there under the watchful eyes of dozens of federal marshals lined  against one of the walls. After eight hours of being poked, prodded, stuck, and poked again, I was given a large red envelope. I had been rejected. I had the respiratory problems of an old man, high blood pressure, partial loss of hearing, very bad teeth, very flat, very wide feet and I tested positive for tuberculosis.
“Frankly,” the doctor said, “I don’t know how the hell you’re even standing ,” and that was when the sergeant told me that if they bottled everything that was wrong with me “we could take over the world without a shot.”
********************

“I had decided that I wanted to earn my living as a writer and the only place in Waterbury where they paid you for writing was at the local newspaper. My opportunity came when the paper had an opening for a night janitor. Opportunities are easy to miss, because they don’t always show  in their best clothes. Sometimes opportunities look like beggars in rags. After an eight-hour shift in the shop tossing thirty-pound crates I hustled  to the newspaper building and cleaned toilets, with a vague plan that it would somehow lead to a reporter’s .”

********************

“One Friday afternoon at the close of the working day the idiot bosses in their fucking ties and suit coats came  and handed out pink slips to every other person on the floor. I got one. They were firing us. Then they turned and, without a word, went back to their offices. Corporate pricks.”

********************

“There is a sense of danger in leaving what you know, even if what you know isn’t much. These mill towns with their narrow lanes and often narrow minds were all I really knew and I feared that if I left it behind, I would lose it and not find anything to replace it. The other reason I didn’t want to go was because I wanted to be the kind of person who stays, who builds a stable and predictable life. But I wasn’t one of the people, nor would I ever be.
I had a vision for my life. It wasn’t clear, but it was beautiful and involved leaving my history and my poverty behind me. I wasn’t happy about who I was or where I was, but I didn’t worry about it. It didn’t define me. We’re always in the making. God always has us on his anvil, melting, bending and shaping us for another purpose.
It was time to change, to find a new purpose.”

********************

“I was tired of fighting the windstorm I was tossed into, and instead I would let go and ride with the winds of change. How bad could it be, compared to the life I knew? I was living life as if it were a rehearsal for the real thing. Another beginning might be rough at first, but any place worth getting to is going to have some problems. I wanted the good life, the life well lived, and you can’t buy that or marry into it. It’s there to be found, and it can be taken by those who want it and have the resolve to make it happen for themselves.”

********************

“Imagine being beaten  every day for something you didn’t do and yet, when it’s over, you keep on smiling. That’s what every day of Donald’s life was like. His death was a small death. No one mourned his passing; they merely agreed it was for the best that he be forgotten as quickly as possible, since his was a life misspent.”

********************

“Then there are all of those children, the ones who aren’t resilient. The ones who slowly, quietly die. I think the difference is that the kids who bounce back learn to bear a little bit more than they thought they could, and they soon understand that the secret to surviving foster care is to accept finite disappointments while never losing infinite hope. I think that was how Donald survived as long as he did, by never losing his faith in the wish that tomorrow would be better. But as time went by, day after day, the tomorrows never got better; they got worse, and he simply gave . In the way he saw the world, pain was inevitable, but no one ever explained to him that suffering was optional.”

********************

“In foster care it’s easier to measure what you’ve lost over what you have gained, because it there aren’t many gains in that life and you are a prisoner to someone else’s plans for your life.”

********************

“I developed an interest in major league baseball and the 1960s were, as far as I’m concerned (with a nod to the Babe Ruth era of the 1920s), the Golden Age of Baseball. Like most people in the valley, I was a diehard Yankees fan and, in a pinch, a Mets fan. They were New York teams, and most New Englanders rooted for the Boston Red Sox, but our end of Connecticut was geographically and culturally closer to New York than Boston, and that’s where our loyalties went.
And what was not to love? The Yankees ruled the earth in those days. The great Roger Maris set one Major League record after another and even he was almost always one hit shy of Mickey Mantle, God on High of the Green Diamond.”
********************

“For the first time in my life, I was eating well and from plates—glass plates, no less, not out of the frying pan because somebody lost all the plates in the last move. Now when we ate, we sat at a fine round oak table in sturdy chairs that matched. No one rushed through the meal or argued over who got the biggest portion, and we ate three times a day.”

********************

 “The single greatest influence in our lives was the church. The Catholic Church in the 1960s differs from what it is today, especially in the Naugatuck Valley, in those days an overwhelmingly conservative Catholic place.
I was part of what might have been the last generation of American Catholic children who completely and unquestioningly accepted the sernatural as real. Miracles happened. Virgin birth and transubstantiation made perfect sense. Mere humans did in fact, become saints. There was a Holy Ghost. Guardian angels walked beside us and our patron saints really did put in a good word for us every now and then.”

********************

“Henry read it and said, “A story has to have three things. They are a beginning, a middle and an end. They don’t have to be in that order. You can start a story at the end or end it in the middle. There are no rules on that except where you, the author, decide to put all three parts. Your story has a beginning and an end. But it’s good. Go put in a middle and bring it back to me.”
I went away encouraged, rewrote the story and returned it to him two days later. Again he looked it over and said, “It’s a good story but it lacks a bullet-between-the-eyes opening. Your stories should always have a knock-’em-dead opening.” Then, looking with exaggerated suspicion around the crime-prone denizens of the room with an exaggerated suspicion, he said loudly, “I don’t mean that literally.”

********************

“A few days after I began my short story, I returned to his desk and handed him my dates. He pushed his wire-rimmed reading glasses way  on his nose and focused on the two pages. “Okay, you got a beginning; you got yourself a middle and an end. You got a wing-dinger opening line. But you don’t have an establishing paragraph. Do you know what that is?”
He didn’t wait for me to answer.
“It’s kinda like an outdated road map for the reader,” he said. “It gives the reader a general idea of where you’re taking him, but doesn’t tell him exactly how you intend to get there, which is all he needs to know.”
********************

“I don’t know’,” he said. “Those three words from a willing soul are the start of a grand and magnificent voyage.” And with that he began a discourse that lasted for several weeks, covering scene-setting, establishing conflict, plot twists, and first- and third-person narration. [ I learned in these rapid-fire mini-dissertations that like most literature lovers I would come to know, Henry was a book snob. He assumed that if a current author was popular and widely enjoyed, then he or she had no merit. He made a few exceptions, such as Kurt Vonnegut, although that was mostly because Vonnegut lived on Cape Cod and so he probably had some merits as a human being, if not as a writer.
I think that the way Henry saw it was that he was not being a snob. In fact I would venture that in his view of things, snobbery had nothing to do with it. Rather, it was a matter of standards. It was bout quality in the author’s craftsmanship.”

********************

 “The foundries were vast, dark castles built for efficiency, not comfort. Even in the mild New England summers, when the warm air combined with the stagnant heat from the machines or open flames in the huge melting rooms where the iron was cast, the effects were overwhelming. The heat came in unrelenting waves and sucked the soul from your body. In the winter, the enormous factories were impossible to heat and frigid New England air reigned sreme in the long halls.
The work was difficult, noisy, mind-numbing, sometimes dangerous and highly regulated. Bathroom and lunch breaks were scheduled  to the second. There was no place to make a private phone call. Company guards, dressed in drab uniforms straight out of a James Cagney prison film [those films were in black and white, notoriously tough, weren’t there to guard company property. They were there to keep an eye on us.
No one entered or the left the building without punching in or out on a clock, because the doors were locked and opened electronically from the main office.”

********************

 “So he sings,” he continued as if Denny had said nothing. “His solo mio, that with her in his life he is rich because she is so beautiful that she makes the sun more beautiful, you understand?” And at that he dropped the hoe, closed his eyes and spread out his arms wide and with the fading sun shining on his handsome face he sang:
Che bella cosa è na jurnata 'e sole
n'aria serena doppo na tempesta!
Pe' ll'aria fresca pare già na festa
Che bella cosa e' na jurnata 'e sole
Ma n'atu sole,
cchiù bello, oi ne'
'O sole mio
sta 'nfronte a te!
'O sole, 'o sole mio
sta 'nfronte a te!
sta 'nfronte a te!
It looked like fun. We dropped our tools and joined him, belting out something that sounded remarkably like Napolitano. We sang as loud as we could, holding on to each note as long as we could before we ran out of breath, and then we sang again, occasionally dropping to one knee, holding our hands over our hearts with exaggerated looks of deep pain. Although we made the words , we sang with the deepest passion, with the best that we had, with all of our hearts, and that made us artists, great artists, for in that song, we had made all that art is: the creation of something from nothing, fashioned with all of the soul, born from joy.
And as that beautiful summer sun set over Waterbury, the Brass City, the City of Churches, our voices floated above the wonderful aromas of the garden, across the red sky and joined the spirits in eternity.”

********************

“It didn’t last long. Not many good things in a foster kid’s life last long. One day, Maura was gone. Her few things were packed in paper bags and a tearful Miss Louisa carried her out to Miss Hanrahan’s black state-owned Ford sedan with the state emblem on the door, and she was gone. The state had found a foster home that would take a little girl but couldn’t take the rest of us. There were no long goodbyes. She was just gone. I remember having an enormous sense of helplessness when they took her. Maura didn’t know where she were going or long she would be there. She was just gone”

********************

“After another second had passed I added, “But you’re pretty, pretty,” and as soon as I said it I thought, “Pretty, pretty? John, you’re an idiot.” But she squeezed my hand and when I looked at her I saw her entire lovely face was aglow with a wonderful smile, the kind of smile you get when you have won something.
“Why do you rub your fingers together all the time?” she asked me, and I felt the breath leave my body and gasped for air. She had seen me do my crazy finger thing, my affliction. I clenched my teeth while I searched for a long, exaggerated lie to tell her about why I did what I did. I didn’t want to be the crazy kid with tics, I wanted to be James Bond 007, so slick ice avoided me.
“It’s okay,” she said. “I bite my nails, see?” and she showed me the backs of her hands. Her finger nails were painted a color I later learned was puce.
“My Dad, he blinks all the time, he doesn’t know why either,” she continued. She looked  her feet and said, “I shouldn’t have asked you that. I’m really nervous and I say stid things when I’m nervous. I’m a girl and this is my first date, and for girls this really is a very big deal.”
I understood completely. I was so nervous I couldn’t feel my toes, so I started moving them  and  to make sure they were still there.
“It’s all right,” I said. “I don’t know why I do that with my fingers; it’s a thing I do.”
“Well, you’re really cute when you do it,” she said.
“I know,” I said, and I don’t know why I said it, but I did.”

********************

“So began my love affair with books. Years later, as a college student, I remember having a choice between a few slices of pizza that would have held me over for a day or a copy of On the Road. I bought the book. I would have forgotten what the pizza tasted like, but I still remember Kerouac.
The world was mine for the reading. I traveled with my books. I was there on a tramp steamer in the North Atlantic with the Hardy Boys, piecing together an unsolvable crime. I rode into the Valley of Death with the six hundred and I stood at the graves of Uncas and Cora and listened to the mournful song of the Lenni Linape. Although I braved a frozen death at Valley Forge and felt the spin of a hundred bullets at Shiloh, I was never afraid. I was there as much as you are where you are, right this second. I smelled the gunsmoke and tasted the frost. And it was good to be there. No one could harm me there. No one could punch me, slap me, call me stid, or pretend I wasn’t in the room. The other kids raced through books so they could get the completion stamp on their library card. I didn’t care about that stid completion stamp. I didn’t want to race through books. I wanted books to walk slowly through me, stop, and touch my brain and my memory. If a book couldn’t do that, it probably wasn’t a very good book. Besides, it isn’t how much you read, it’s what you read.
What I learned from books, from young Ben Franklin’s anger at his brother to Anne Frank’s longing for the way her life used to be, was that I wasn’t alone in my pain. All that caused me such anguish affected others, too, and that connected me to them and that connected me to my books. I loved everything about books. I loved that odd sensation of turning the final page, realizing the story had ended, and feeling that I was saying a last goodbye to a new friend.”

********************

“I had developed a very complicated and little-understood disorder called misophonia, which means “hatred of sound.” Certain sounds act as triggers that turn me from a Teddy bear into an agitated grizzly bear. People with misophonia are annoyed, sometimes to the point of rage, by ordinary sounds such as people eating, breathing, sniffing, or coughing, certain consonants, or repetitive sounds. Those triggers, and there are dozens of them, set off anxiety and avoidant behaviors.
What is a mild irritation for most people -- the person who keeps sniffling, a buzzing fly in a closed room—those are major irritants to people with misophonia because we have virtually no ability to ignore those sounds, and life can be a near constant bombardment of noises that bother us. I figured out that the best way to cope was to avoid the triggers. So I turned off the television at certain sounds and avoided loud people. All of these things gave me a reputation as a high-strung, moody and difficult child. I knew my overreactions weren’t normal. My playmates knew it”

********************

“Sometimes in the midst of our darkest moments it’s easy to forget that it’s  to us to turn on the light, but that’s what I did. I switched on the light, the light of cognizance.”

********************

 “I don’t know what I would have done if they had hugged me. I probably would have frozen in place, become stiff. It took most of my life to overcome my distaste for physical contact and not to stiffen when I was touched, or flinch, twitch, fidget, and eventually figure out how to move away. I learned to accept being hugged by my children when they were infants. Their joy at seeing me enter a room was real and filled with true love and affection and it showed in their embraces. Like a convert, when I learned the joy and comfort of being hugged by and hugging those I loved, I became a regular practitioner.”

********************

“Most people don’t understand how mighty the power of touch is, how mighty a kind word can be, how important a listening ear is, or how giving an honest compliment can move the child who has not known those things, only watched them from afar. As insignificant as they can be, they have the power to change a life.”

********************
 “They were no better than common thieves. They stole our childhood. But even with that, I was heartbroken that I would not know the Wozniaks anymore, the only people who came close to being parents to me. I would be conscious of their absence for the rest of my life. I needed them. You know, if you think about it, we all need each other. But even with all of the evidence against the Wozniaks, I had conflicted emotions about them, then and now. They were the closest I had to a real family and real parents.
But now I was bankrt of any feelings at all towards them at all.
I felt then, and feel now, a great sense of loss. I felt as if I were burying them. when I never really had them to lose in the first place. Disillusioned is probably a better word. In fact the very definition of disillusionment is a sense of loss for something you never had. When you are disillusioned and disappointed enough times, you shoping. That’s what happens to many foster kids. We become loners, not because we enjoy the solitude, but because we let people into our lives and they disappoint us. So we close  and travel alone. Even in a crowd, we’re alone.
Because I survived, I was one of the lucky ones. Why is it so hard to articulate love, yet so easy to express disappointment?”

********************

“My first and lasting impression of the Connecticut River Valley is its serene beauty, especially in the autumn months. Deep River was a near picture-perfect New England village. When I arrived there, the town was a typical working-class place, nothing like the trendy per-income enclave it became. The town center had a cluster of shops, a movie theater open only on weekends, several white-steepled churches (none of them Catholic), the town hall, and a Victorian library. It was small, even by Ansonia standards.”

********************

 “While I may not have been a bastion of good mental health, many of these boys were on their way to becoming crazier than they already were. Most couldn’t relate to other people socially at all, because they only dealt inappropriately with other people or didn’t respond to overtures of friendship or even engage in basic conversations.
Some became too familiar with you too fast, following their new, latest friend everywhere, including the showers, insisting on giving you items that were dear to them and sharing everything else. They also had the awful habit of touching other people, putting their hands on you as a sign of affection or friendship, and for people like myself, with my affliction and disdain for being touched unless I wanted to be touched, these guys were a nightmare. It was often difficult to get word in edgewise with these kids, and when I did, they interrted me—not in some obnoxious way, but because they wanted to be included in every single aspect of everything you did.
The other ones, the stone-cold silent ones, reacted with deep suspicion toward even the slightest attempt to befriend them or the smallest show of kindness. If you touched some of these children, even accidentally, they would warn you to back away. They didn’t care what others thought of them or anything else, and almost all their talk concerned punching and hurting and maiming.
I noticed that most of these kids, the ones who were truly damaged, were eventually filtered out of St. John’s to who knows where. Institutions have a way of protecting themselves from future problems.”

********************

“Jesus,” I prayed silently, “please fix it so that my turn to read won’t come around.”
And then the nun called my name, but before I stood I thought, “I’ll bet you think this is funny, huh, Jesus?”
I stood and stared at the sentence assigned to me and believed that, through some miracle, I would suddenly be able to read it and not be humiliated. I stood there and stared at it until the children started giggling and snickering and Sister told me to sit.”

********************

 “My affliction decided to join us, forcing me to push my toes on the floor as though I were trying to eject myself from the chair. I prayed she didn’t notice what the affliction was making me do. I half expected to be eaten alive or murdered and buried out back in the school yard.
“I’m not afraid of you, ya know,” I said, although I was terrified of her. The words hurt her, but that wasn’t my intent. She turned her face and looked out the window into North Cliff Street. She knew what her face and twisted body looked like, and she probably knew what the kids said about her. It was probably an open wound for her and I had just tossed salt into it.
I was instantly ashamed of what I done and tried to correct myself. I didn’t mean to be hurtful, because I knew what it was like to be ridiculed for something that was beyond one’s control, such as my affliction, and how it made me afraid to touch the chalk because the feel of chalk to people like me is overwhelming. If I had to write on the blackboard, I held the chalk with the cuff of my shirt and the class laughed.
“You look good in a nun’s suit,” I said. It was a stid thing to say, but I meant well by it. She looked  at the black robe as if she were seeing it for the first time.”

********************

“Jews were a frequent topic of conversation with all of the Wozniaks, which was surprising, since none of them had any contact at all with anything even remotely Jewish.
While watching television, Walter would point out who was and who was not Jewish and Helen’s frequent comment when watching the television news was, “And won’t the Jews be happy about that!” To bargain with a merchant for a lower price was to “Jew him ,” and that sort of thing.
Walter’s mother and father were far worse. They despised the Jews and blamed them for everything from the start of World War I to the Kennedy assassination to the rising price of beef.
I didn’t pay much heed to any of this. It wasn’t my problem, and if I were to think through all the ethnic, racial and religious barbs the Wozniaks threw out in the course of a week, I’d think about nothing else.
After being told about a part of my mother’s heritage, the Wozniaks began their verbal and cultural assault against us. As odd as it sounds, they might not always have intended to be mean.”

********************

“Explaining the Jews in a Catholic school when you’re Irish is like having to explain your country’s foreign policy while on a vacation in France. You don’t know what you’re talking about and no matter what you say, they’re not going to like it anyway.”

********************

 “You could read the story of his entire life on his face in one glance.”

********************

 “As interesting as that was, it didn’t inspire me. What did was that here was a Jew who was tough with his fists, a Jew who fought back. The only Jews I had ever heard of surrendered or were beaten by the Romans, the Egyptians, or the Nazis. You name it, it seemed like everyone on earth at some point had taken their turn slapping the Jews around. But not Benny Leonard. I figured you’d have to kill Benny Leonard before he surrendered.”

********************

“One afternoon Walter brought Izzy to the house for lunch and, pointing to me, he said to Izzy, “He’s one of your tribe.”
Dobkins lifted his head to look at me and after a few seconds said, “I don’t see it.”
“The mother’s a Jew,” Walter answered, as if he were describing the breeding of a mongrel dog.
“Then you are a Jew,” Izzy said, and sort of blessed me with his salami sandwich.”

********************

“Sometimes a man must stand for what is right and sometimes you must simply walk away and suffer the babblings of weak-minded fools or try to change their minds. It’s like teachin’ a pig to sing. It is a waste of your time and it annoys the pig.”

********************

 “Father, I can’t take this,” I said.
“Why not?”
“Because you’re a priest, Father.”
“And my money’s no good because of it? What are you? A member of the Masonic Lodge?”
“Naw, Father,” I said. “I just feel guilty taking money from you.”
“Well, you’re Irish and Jewish. You have to feel guilty over somethin’, don’t ya? Take the money and be happy ye have it.”
― John William Tuohy, No time to say goodbye: memoirs of a life n foster care

********************

 “I caddied—more accurately, I drove the golf cart—for Father O’Leary and his friends throughout most of the summer of that year. I was a good caddie because I saw nothing when they passed the bottle of whiskey and turned a deaf ear to yet another colorful reinvention of the words “motherless son of a bitch from hell” when the golf ball betrayed them.”

********************

“Weeks turned into months and a year passed, but I didn’t miss my parents. I missed the memory of them. I assumed that part of my life was over. I didn’t understand that I was required to have an attachment to them, to these people I barely knew. Rather, it was my understanding that I was sposed to switch my attachment to my foster parents. So I acted on that notion and no one corrected me, so I assumed that what I was doing was good and healthy.”

********************

“I felt empty a lot and I sometimes had a sense—and I know this sounds strange—that I really had no existence as my own person, that I could disappear and no one would notice or remember that I had ever existed. It is a terrifying thing to live with. I kept myself busy to avoid that feeling, because somehow being busy made me feel less empty.”

********************

“Denny thought our parents needed a combination of material goods and temperamental changes before he could return home.
“If Dad buys Ma a car, then she’ll love him, and they’ll get back together and she won’t be all crazy anymore,” he said. For years he held out the possibility that those things would happen and all would change. “If we had more things, like stoves and cars,” he told me at night in our bedroom, “and Ma wasn’t like she is, we could go home.”

********************

 “Because we were raised in a bigoted and hate-filled home, we simply assumed that calling someone a “cheap Jew” or saying someone “Jewed him ” were perfectly acceptable ways to communicate. Or at least we did until the day came when I called one of the cousins, a Neanderthal DeRosa boy, “a little Jew,” and he told me he wasn’t the Jew, that I was the Jew, and he even got Helen and Nana to confirm it for him.
It came as a shock to me to find out we were a part of this obviously terrible tribe of skinflint, trouble-making, double-dealing, shrewdly smart desert people. When Denny found out, he was crestfallen because he had assumed that being Jewish meant, according to what his former foster family the Skodiens had taught him, a life behind a desk crunching numbers. “And I hate math,” he said, shaking his head.
So here we were, accused Jews living in a hotbed of anti-Semitism. Not a good situation. Walter’s father was the worst. Learning about our few drops of Jewish blood seemed to ignite a special, long-held hatred in him. He became vile over nothing, finding any excuse to deride the Jews in front of us until Helen made him stop. We didn’t know what to make of it, except to write it off as another case of Wozniak-inspired insanity, but as young as we were, we could tell that at some point in his life he had crossed swords with a Jew someplace and came out on the losing end and we were going to pay for it. But because we really didn’t feel ourselves to be Jews, it didn’t sink in that he intended to hurt us with his crazy tirades. As I said, it’s hard to insult somebody when they don’t understand the insult, and it’s equally hard to insult them when they out and out refuse to be insulted.
Word got around quickly.”

********************

“I hit him for every single thing that was wrong in my life and kicked him in a fierce fury of madness as he sobbed and covered his face and screamed. I hit him because Walter hit me and I hit him because I hated my life and I hit him because I just wanted to go home and I hit him because I didn’t know where home was.”
********************

 “I also told him about the dramatic, vivid verbal picture of God that the nuns drew for us—an enormous, slightly dangerous and very touchy guy with white hair and a long white beard.
“It’s all the talk of feeble minds,” he whispered to me in confidence. “Those nuns know as much about prayer as they do about sex. Listen to me, now. God is everywhere and alive in everything, while them nuns figured God is as good as dead, a recluse in a permanently bad mood. Well, I refuse to believe that to my God, my maker and creator, my life is little more than a dice game.” He stopped and turned and looked at me and said, “Never believe that a life full of sin puts you on a direct route to hell. Even if you only know a little bit about God, you learn pretty quick that he’s big on U-turns, dead stops and starting over again.”
As each day passes and my memories of Father O’Leary and Sister Emmarentia fade, and I can no longer recall their faces or the sounds of their voices as clearly as I could a decade ago, what remains, clear and uncluttered, are the lessons I took from them.”

********************

 “Eventually, many years later, I came to see him the way everyone else saw him—a nice guy who, despite all the damage he did to us, wasn’t a bad man, not inherently bad, anyway. He just wasn’t very bright, and was in over his head on almost every level of life. He was capable of only so much and not a drop more, and because he seemed so harmless and lost, people not only liked him, they protected him.
My mother, despite her poverty, left the opposite impression. She left no doubt that she was psychologically tough and mentally sharp, and because of that the Wozniaks disliked her.
And that was another difference between my mother and father. My father was a whiner, a complainer, a perpetually unhappy man unable to comprehend the simple fact that sometimes life is unfair. My mother never complained, and yet her poverty-stricken life was miserable. She never carried on about the early death of her raging alcoholic mother, or the father who raped her, or of a diet dictated by the restrictions of food stamps.”
********************