O.D. Scene
THE ENTERTAINING SIDE OF OPTOMETRY
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O.D. Scene creator, writer and editor Jack Schaeffer, O.D.
Nutraceuticals, which we can prescribe, can benefit our patients and our practices. In realizing I can play a profound role in the ocular and systemic health of my patients, I’ve been spending a considerable amount of time researching nutraceuticals. In addition, I’ve been talking with our optometric colleagues who specialize in this area to get their recommendations. One of these individuals is Jeffrey Anshel, O.D., who’s president and founder of the Ocular Nutrition Society (www.ocularnutritionsociety.org). Another one: Stuart Richer, O.D., Ph.D., F.A.A.O., the ONS’ Research Committee Chair.
Further, I recently had the pleasure of meeting and chatting with Canadian O.D.s Laurie Capogna and Barbara Pelletier, who published the books Eyefoods: A Food Plan for Healthy Eyes and Eyefoods for Kids: A Tasty Guide to Nutrition and Eye Health. (See www.optometricmanagement.com/articleviewer.aspx?articleID=109272.)
Here, I speak with all four about nutrition and the eye, as well as their outside interests.
Key Opinion Leaders Weigh in…
Jeff Anshel, O.D., Carlsbad, Cal., Laurie Capogna, O.D., Niagara Falls, Ontario, Barbara Pelletier, O.D., Niagara Falls, Ontario, and Stuart Richer, O.D., Ph.D., F.A.A.O., North Chicago, Ill.
Q: Why are you so involved with the ONS?
JA: The group was my idea. I used to sit in lectures about nutrition that were either promotions for specific companies or just “soft” science, so I decided that our profession needed a scientifically based source of nutrition science.
LC: I am passionate about educating people about the power of food and lifestyle in maintaining long-term ocular health. The ONS provides great resources and education to support my mission.
BP: There is a great need to educate patients about the power of food to help prevent eye disease, and members of the ONS are interested and/or active on the subject.
SR: I enjoy helping like-minded practitioners improve the care of their patients.
Q: Why should an O.D. consider ONS membership?
JA: Increasing research links the most common chronic eye disorders, such as AMD, with nutrition. Doctors must know more about nutrition because it’s the basis of human existence, and we need to remember that the eyes are connected to the body.
LC: Educating our patients about ocular nutrition is essential to provide them with the most current and complete eye care. ONS gives you access to accurate and current information on ocular nutrition, as well as an opportunity to interact with the brightest minds in the field.
BP: As optometrists, we are bound to educating patients about nutrition and eye health. We must be a reliable source of information. The ONS is a great source of research papers and enables the optometrist to learn from experts and interact with other O.D.s through its forum.
SR: Primarily because the society provides beneficial actionable information for patients not available from other sources. Integrative eye care is high-quality eye care without compromise.
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Dr. Pelletier “sampling.”
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Dr. Richer at a speaking event in Portugal.
Q: What are the benefits to a practice that promotes ocular nutrition?
JA: Nutrition fits into the model of “lifestyle counseling” whereby we “partner” with our patients in helping them see better through healthy eyes for their entire lifetime.
LC: We have the power to motivate and inspire our patients to make better everyday choices that will lead them to a lifetime of healthier eyes.
BP: Patients are thankful for the information, and providing this education elevates our status as a doctor, leading to patient loyalty and referrals.
SR: An expanded therapeutic repertoire that provides better eye health as well as beneficial systemic health outcomes at a fraction of the cost.
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Q: If you could have dinner with anyone living or deceased, who would it be and why?
JA: Leonardo da Vinci (photo right). His mind was forever searching for new ideas, and his creativity was amazing.
LC: My father. He passed away the year I graduated from Optometry school. I would love him to see the fulfillment that I have from my profession and that his hard work to put me through university was worth it.
BP: My mother-in-law. She died of cancer before my husband and I got married. They were so close! He was her pride and joy. I would love her to see how happy he is, and I would love her to meet her two amazing granddaughters.
SR: Kazimierz Funk, commonly known as Casimir Funk. He was a Polish biochemist, and he’s generally credited with being among the first to come up with the concept of vitamins in 1912.
Q: Should optometrists sell vitamins, and if so, how does one determine the most reputable brands?
JA: I consider nutritional supplements an additional benefit, like eyeglasses and contact lenses, for my patients. If they trust me and the products I recommend, they have more confidence in the treatment. If I just send them to the drugstore with no specific recommendation, I’m not sure that what they buy — if they buy anything — is beneficial.
To learn which vitamin brands are the best, there is a LONG learning curve. It helps if the company you’re looking at has the scientific rationale on their website to review. Reviewing the studies on ocular nutrition — all located on the ONS website — also helps someone decide whether certain nutrients are effective for a particular condition.
LC: Yes, to provide their patients with the most complete care. We must find the best product for each patient, and make specific recommendations. So many vitamins and supplements are available at pharmacies and health food stores, that even if you recommend a specific one, you can’t be sure the patient will buy the right one.
To determine the most reputable vitamin brands, read the current journals, attend nutrition lectures, talk to industry experts, attend trade shows, and learn about the new products available.
BP: There are so many ocular supplements on the market, and not all are created equal. Selling ocular supplements is a great way to ensure your patients buy the correct product, and doing so ensures compliance because you, the doctor, have prescribed it.
SR: Absolutely!
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Dr. Anshel and son snorkling in Maui.
Q: What is the most amazing, game-changing discovery in vitamin therapy today?
JA: In eye care, the role of macular carotenoids has been a game-changer, but more information continues to be discovered. However, it’s a marathon, and the goal is still down the road.
LC: Individualized nutrition recommendations based on genetic testing. A study published in November 2013’s Ophthalmology shows certain genetic profiles benefit from supplementation with zinc, while others benefit from anti-oxidant supplements alone.
BP: I agree with Laurie: genetic testing allowing us to make individualized zinc supplementation recommendations.
SR: Epigenetics, or changing the expression of DNA. It often involves small stress in the form of low molecular weight molecules at low doses, such as resveratrol in red wine and allicin in crushed garlic. Such nutrients activate endogenous broad-spectrum cellular protective systems. That is, one molecule can have multiple biologic actions in the body through methylation, DNA protein histone wrapping/unwrapping and micro RNA signaling, replacing a bucket of pharmaceuticals and far more safely.
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“Kale is fun,” reveals Dr. Capogna.
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Drs. Pelletier and Capogna creating an eye-healthy dish.
Q: What’s your favorite guilty-pleasure snack food, and how do you keep yourself from over-indulging?
JA: Chocolate (It’s still sugar). I try to keep it down to “one bite” at a time, not one box at a time.
LC: Potato chips are my absolute favorite snack food. The only way to keep myself from over-indulging is to not have them in the house, but every so often I treat myself!
BP: Praline nuts: I mix them with regular raw nuts and only serve myself a small amount. Then I enjoy every single one.
SR: Pizza and other gluten-containing foods. I pop a 500mg vitamin C capsule to dampen the gastrointestinal distress and hope for the best.
Q: What is your prediction for the future of the optometric profession?
JA: Hopefully, our profession will continue to expand in offering true primary care options to our patients, which includes lifestyle modifications to support eye health.
LC: I see a future where every O.D. is proactive and educating all their patients about prevention. If we can inspire our patients to be healthy and make appropriate food and lifestyle choices, we will have a future with less vision loss.
BP: I see a future where optometrists have a section of their eye examination dedicated to ensuring their patient’s eyes are receiving proper nutrition and, if not, supplements or dietary recommendations are prescribed. Optometrists and their patients will understand the importance of a proactive approach when it comes to eye disease prevention through nutrition and lifestyle.
SR: I see the collapse of conventional medicine because it is all too often expensive and dangerous. It should be replaced, where possible, by self-care and integrative medicine.
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Dr. Richer and colleagues at the Captain James A. Lovell Federal Health Care Center.
Q: Who are the members of your family, and what do you like to do for fun?
JA: My ex-wife is my best friend. She lives in the wine country in the south of France. Our son is an open-ocean kayak guide on the North Shore of Kauai. Yes, I go visit every chance I get. In my “spare” time, I love to garden, walk the local beach and work out. Also, I have a koi pond (with 20 fish), so they are my other friends.
LC: My husband and I have been married for 15 years, and he is the funniest person I know. We have many nieces and nephews that we dote on and love to travel with. For fun, I love to throw small dinner parties for my family and friends — always featuring new recipes and wine discoveries. Also, my husband and I love to travel and discover new foods and customs in different countries. And I guess I should admit that I love to shop, and I practice yoga regularly to help keep me balanced.
BP: My husband and I got married in 2002. We have two beautiful daughters who are two years apart. Our extended family is in Quebec. For fun, I love to travel, run, road bike, hike and downhill ski with family. I also love taking long, challenging bike rides alone or with my husband, creating new recipes, shopping, and I occasionally play the flute.
SR: I’m married to an attorney. I have four grown children who are all headed to work in different fields: medicine, film direction, human resources and economics. For fun, I enjoy photography, classical piano, combo strength training, yoga and interval cardio and watching women’s basketball.
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Dr. Pelletier loves creating new healthy recipes.
Q: What is your favorite movie, book, band and adult beverage?
JA: Movie: Animal House; Book: Smart Medicine for Your Eyes: A Guide to Natural, Effective, and Safe Relief of Common Eye Disorders; written by me. Band: The Moody Blues and Eagles; Adult beverage: a bottle of red wine.
LC: Movie: Under the Tuscan Sun; Book: Eyefoods, of course; Band: U2 and Bon Jovi; Adult beverage: Mojito (enjoyed by the pool on a hot summer day).
BP: Movie: The Lion King; Book: Eyefoods and Eyefoods for Kids; Band: U2, Adult beverage: champagne.
SR: Movie: Groundhog Day; Book: Tarnished Gold: The Sickness of Evidence-based Medicine; Band: The Moody Blues; Adult beverage: Guinness Black Lager.
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Dr. Anshel with his girlfriend on a trip to Hawaii’s Kauai.
Q: What is the most incorrect widely published information about nutrition?
JA: That carrots are good for your eyes. (See www.optometricmanagement.com/articleviewer.aspx?articleID=107792.)
LC: “Eat egg whites only.” The yolk is the most nutritious part of the egg, especially for ocular health. It is a good, bioavailable source of lutein, as well as vitamin E, zinc and DHA (for omega-3 eggs).
BP: I’m with Dr. Anshel. A WWII propaganda campaign popularized the myth that carrots help you see in the dark. Through the years, this message that carrots are good for your eyes became dis gured into improving eyesight.
SR: That one can obtain adequate vitamin D suf ciency from drinking milk. Until recently, most people made vitamin D from sunlight-exposed skin. We now live indoors, and this has the most adverse impact on “people of color” living in northern climates who suffer disproportionately from autoimmune disease, cardiovascular disease and cancer(s).
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