Issue: 59

December: Christmas, A Pause for Peace!
With all the turbulence in the world, both home and abroad, many of us are longing for a few days of peace. The intense longing for an end of year respite is nothing new. Listen to what Charles Dickens wrote in The Posthumous Papers of the Pickwick Club in 1836: "And numerous indeed are the hearts to which Christmas brings a brief season of happiness and enjoyment. How many families whose members have been dispersed and scattered far and wide, in the restless struggles of life, are then re-united, and meet once again in that happy state of companionship and mutual goodwill, which is a source of such pure and unalloyed delight, and one so incompatible with the cares and sorrows of the world, that the religious belief of the most civilized nations, and the rude traditions of the roughest savages, number it among the first joys of a future state of existence, provided for the blessed and happy! How many old recollections, and how many dormant sympathies does Christmastime awaken!"
One cannot have peace without hope. To restore your hope read excerpts of this famous editorial published in the New York Sun on Sept 21, 1897, in response to a letter from Virginia O'Hanlon, only eight years old: "Yes, Virginia, there is a Santa Claus. He exists as certainly as love and generosity and devotion exist...The most real things in the world are those that neither children nor men can see...There is a veil covering the unseen world which not the strongest men...can tear apart. Only faith, poetry, love, (and) romance can push aside that curtain and view and picture the supernal beauty and glory beyond!
No one is more hopeful than a pregnant mother, captured so beautifully by Amy Grant when she first recorded, " Breath of Heaven" (Mary's Song) in 2008. For an anthem of hope, listen to "Mary Did You Know" by Pentatonix.

Our third daughter is in her third trimester and she said that the words of this beautiful hymn never meant more to her than they do now!! Be with us now, Breath of Heaven - Hold Us Together - Please!!
John A. Schmidt, MD 
Santa Has Been Busy at Our New Location!
With furniture and equipment arriving almost every day at our new location at 2006 Route 71, Spring Lake Heights, 07762, Santa's elves have been busy installing high tech equipment to serve you better in 2017! Located on the second floor of the Christine Keating Building across from Hoffman's Ice Cream and Yogurt, on the corner of Route 71 and Church Street, our stockings have been overflowing with requests for appointments to kick off a Healthy New Year! A personalized invitation announcing our new address will be arriving at your home soon. Our telephone, email, and web addresses remain the same.
Dr. Schmidt's New Office
New Appointment Reminder System
To better serve you, you will now have the option of receiving appointment reminders by voicemail or text messaging. Please leave a message with Valerie at 732-282-8166 after January 1, 2017 specifying your preference. If you don't have a smart phone, we will continue to remind you by telephone. 
A Warm Welcome to Patients of Miguel Maseda, M.D.!
Dr. Maseda has recently retired after providing compassionate service to his patients for more than 35 years! We have happily shared the same office and staff for the past six years at our current location in Belmar. The best way I can celebrate my colleague and friend is to carry on his tradition of personalized care. Dr. Maseda's telephone and FAX numbers were ported to mine on Monday, December 18th.

With your permission, I will have access to Dr. Maseda's medical records so you and I can hit the ground running in 2017! Please call Valerie at 732-282-8166 to make an appointment today! 
Do Your Genes Influence Your Risk of a Heart Attack?
As published in a landmark study in the December 15 issue of the New England Journal of Medicine, the answer is resoundingly yes! Using a sophisticated panel of more than 50 SNPs ( single nucleotide polymorphisms), the authors showed that those with the least favorable SNP profiles had nearly double the coronary risk. Though this test is not, to the best of my knowledge, commercially available, one has to believe that it will be soon. The authors point out that coronary calcium score, available for less than $200 at Jersey Shore University Medical Center, is a good substitute. Connecting the dots, bad SNPs lead to a high coronary calcium score, high coronary calcium score correlates with high plaque burden, and high plaque burden correlates with high risk of heart attack, the leading cause of death in the U.S.
Now for the good news. You may have heard doctors, myself included, say, "Focus on the "modifiable" risk factors for coronary disease, namely, smoking, hypertension, diabetes, and hypercholesterolemia because there is nothing you can do about your genes." Wrong!! As the authors demonstrate, a healthy lifestyle including not smoking, avoiding obesity ( BMI < 30), regular physical activity (thirty minutes five times a week), and a healthy ( Mediterranean) diet reduced coronary risk in each genetic category. In those with the worst SNP profile, coronary events were cut in half by ten years! Bottom line: Even genetic predisposition to coronary disease can be significantly mitigated by lifestyle modification, your best New Year's resolution for 2017!
Please Pass the Crudité!
As mentioned above, a Mediterranean style diet rich in vegetables (with the exception of white potatoes - too many carbs!!) reduces cardiac risk. Why? As beautifully reviewed in the December 15 issue of the New England Journal of Medicine, the answer probably lies in a complex interaction between the microorganisms in our intestines ( Intestinal Microbiome), and the food we eat. As the authors point out: "The human gastrointestinal tract represents a large microbial ecosystem, housing several trillion microbial cells with an aggregate 9.9 million microbial genes...!" Compare this number to the paltry 25,000 genes in the human genome and you can see why sequencing your own genes does not begin to give a complete picture! Colonization occurs before birth with "bacterial species present in the placentas of healthy mothers, in amniotic fluid of preterm infants, and in meconium" making the ongoing debate regarding vaginal vs. cesarean birth more complex than ever!
Now back to the topic of diet and coronary disease. Studies cited by the authors show that dietary phosphatidylcholine and L-carnitine, substances most abundant in red meat and egg yolks and recommended by muscle builders, are converted by gut microbiota to trimethylamine-N-oxide (TMAO), a strong risk factor for atherosclerotic coronary artery disease in humans and animals. It therefore came as no surprise when Dr. Oz retracted his recommendation of L-carnitine as a dietary supplement! The concentration of phosphatidylcholine and L-carnitine in plants is much lower meaning you should have more green on your plate in 2017!
U.S. Life Expectancy Falls for the First Time in Two Decades
As reported by the Centers for Disease Control (CDC) on December 8, life expectancy in 2015 at birth for the entire U.S. population was 78.8 years, a decrease of 0.1 year from 78.9 in 2014, reversing a twenty-three-year record of improvement. For males, life expectancy declined from 76.5 years in 2014 to 76.3 years in 2015; for females, life expectancy decreased from 81.3 to 81.2 years. The difference in life expectancy between females and males increased 0.1 per year from 4.8 years in 2014 to 4.9 years in 2015.
Higher death rates for black males, white males, and white women accounted for the overall decline in life expectancy. Death rates increased for nine of the ten leading causes of mortality (in order of incidence: heart disease, emphysema, accidental injuries, stroke, Alzheimer's Disease, diabetes, influenza/pneumonia, kidney disease and suicide) with only cancer experiencing a lower year-over-year death rate. The nearly across-the-board increase in death rates made it difficult to identify any single cause for the setback though some commentators speculated that the economic downturn may have played a role, knowing that zip codes with the lowest per capita income already have the shortest life expectancy.
For those contemplating retirement: In 2015, life expectancy at age 65 for the total population was 19.4 years, the same as in 2014. Life expectancy at age 65 was 20.6 years for females and 18 years for males, both unchanged from 2014. The difference in life expectancy at age 65 between females and males therefore remained 2.6 years in 2015.
Now Hear This!
The office will be closed the week between Christmas and New Years to allow us time to move and set up our new office in Spring Lake Heights. We reopen on Jan 2.
For medical emergencies and problems that cannot wait, contact me on my cell phone or through the answering service. As always, refill requests should be initiated through your pharmacy. I will continue to read email and messages sent through our Patient Portal.
Valerie, Ms. Clark, and I wish our cherished patients the Most Peaceful of Holidays and a Spectacularly Healthy New Year! In celebration of the holidays, a donation was made to Holiday Express in honor of our patients. The Holiday Express mission is to deliver music, food, gifts, financial support and friendship to those with the greatest need for the gift of human kindness during the holiday season and throughout the year.
In This Issue
December: Christmas, A Pause for Peace
Santa Has Been Busy at Our New Location
New Appointment Reminder System
A Warm Welcome to Patients of Dr. Maseda
Do Your Genes Influence Your Risk of a Heart Attack?
Please Pass the Crudité
U.S. Life Expectancy Falls for the First Time in Two Decades
Now Hear This!
John A. Schmidt Jr., M.D.
Board Certified Internist
Dr. Schmidt is one of the leading internists in Monmouth County offering  Medical Home  services.  
He is an Associate Attending in the Department of Medicine, Jersey Shore University Medical Center, and  Clinical Assistant Professor in the Department of Medicine, Rutgers Robert Wood Johnson Medical School.
Dr. Schmidt is enrolled in the Maintenance of Certification Program of the American Board of Internal Medicine
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"Blessed is the season which engages the whole world in a conspiracy of love."    

 - Hamilton Wright Mabie

John A. Schmidt Jr., MD
Meaningful Medicine in Your Medical Home
709 Seventh Avenue
Belmar, NJ 07719
Phone:  732-282-8166  
Fax:  732-280-0147 
Disclaimer: The articles in Healthy Living are  for general information only and are not medical advice.
Discuss all medical concerns and treatment options with your physician.