Feeding Armenia – Kim Hekimian’s Prescription for a Thriving Population: Nutrition Comes First

Published by Laura L. Constantine, AGBU Insider

Dr. Hekimian speaks at an AUA conference titled Nutrition Today Matters Tomorrow.

The long list of professional credits and affiliations attached to the name Kim Hekimian, PhD, only skims the surface of the remarkable career of this Armenian-American nutrition and public health expert. Juggling a demanding career in America, she has managed to transfer her wealth of knowledge, academic discipline, and lived experiences to what has evolved into a life mission: to save lives and improve health outcomes in the Republic of Armenia.

Over the past 30 years, Hekimian has built an impressive reputation in the field of Public Health, as an Associate Professor of Nutrition (in Pediatrics) and the Institute of Human Nutrition at Columbia University in New York. There she serves in many capacities—educator, researcher, mentor, and advisor. She is also an active member of professional health organizations and boards, among them the Armenian-American Health Professionals Organization (AAHPO). However, this is only one side of the multi-dimensional story of her inspired life.

On the flip side, the ardent advocate for maternal and child nutrition has gone to Armenia almost every year since it gained independence in 1991. In those early days, she was one of around 20 diasporan Armenians in the country, working on her PhD and soon joining the faculty of the American University of Armenia (AUA). Recently, she added the title of Advisor to the Armenian Ministry of Health to her resume, along with her appointment as Senior Policy Fellow of the Applied Policy Research Institute of Armenia, better known as APRI.

Her data-driven presentations and analysis-rich lectures to health care peers in and out of Armenia are balanced with a very humanistic approach to patient populations. This stems from spending many successive summers living among Armenian families in the Lake Sevan region of Armenia and observing firsthand how poverty, scarcity, misinformation, and traumatic events can compromise health potentials. While she did not grow up in an Armenian speaking home, she eventually became fluent in Eastern Armenian through her interactions with peers and locals over the decades.

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Massive Recall of Ground Beef Products

Photo by Angele J

Numerous beef products have been recalled over fears that they may have been contaminated with E.coli, the U.S. Food Safety and Inspection Service (FSIS) has announced.

Six ground beef products produced by Cargill Meat Solutions of Pennsylvania are being recalled by the FSIS after a previously “segregated product” was

inadvertently used in the production of ground mince and burger patties. In all, 16,243 pounds of raw beef is believed to be affected.

Cargill Meat Solutions said the products have been shipped to Walmart stores in 12 states: Connecticut, Washington DC, Massachusetts, Maryland, North Carolina, New Hampshire, Virginia, West Virginia, Ohio, Pennsylvania, Vermont, and New York. All products have an establishment number of “EST. 86P” printed on the back of the label.

The FSIS has said consumers should check their refrigerators or freezers, and any affected purchases should not be consumed and either be thrown away or returned to the store. For any customers with queries regarding the recall, Cargill has set up a consumer hotline at 1-844-419-1574.

Who Needs a Colonoscopy and When?

No one loves the preparation for a colonoscopy, but by staying up to date on yours, you’re greatly reducing your risk of colon and rectal cancer, sometimes referred to collectively as colorectal cancer. Regular colonoscopies can catch these cancers early, when they’re easiest to treat, and can even prevent them altogether.

“As Gastroenterologists (GI doctors), we do our best to remind everyone how important a colonoscopy or other screening methods can be. Unfortunately, we are seeing more and more patients being diagnosed with colon cancer at a younger age,” noted AAHPO member and Gastroenterologist Vahe Shahnazarian, MD MPH.

People who have no family history or symptoms of colorectal cancer should get their first colonoscopy at age 45, Dr. Shahnazarian said. That guideline has changed in recent years based on a troubling and so far unexplained trend of more young people being diagnosed with colon cancer.

“One common story I hear from patients or their family members is that they did not go for their colonoscopy because they felt fine and had no symptoms or complaints. However, the purpose of a screening procedure, like a colonoscopy, is to prevent the symptoms (and the cancer) from ever occurring. By the time you develop symptoms, we are typically dealing with an aggressive cancer, as opposed to either completely preventing the cancer or having a scenario with a much better outcome,” Dr. Shahnazarian observed.

Symptoms to call your doctor about include rectal bleeding, abdominal pain, weight loss, a change in bowel habits, and anemia.

“For those who are just opposed to colonoscopy for whatever reason, there are non-procedural tests that can be done, such as the Cologuard stool test. While these tests are not as accurate as a colonoscopy, they are still good screening tests and are better than not being screened at all,” Dr. Shahnazarian said. “In short, please speak to your Gastroenterologist about when you should be screened and what options you have. And like all my patients say, when you have a colonoscopy, it will be the best sleep you’ve ever had!”

The Pros, Cons and Unknowns of Popular Weight-Loss Drugs

Troy Kalajian MDEditors note: In the news, celebrities like Oprah Winfrey are showing off trimmer figures attributed to weight-loss drugs. AAHPO member and medical weight loss expert Tro Kalayjian, MD:

“Many of my patients have come to me with questions about this new class of medications that are being used for both diabetes and weight loss. The new blockbusters are called Ozempic, Wegovy, and Mounjaro and seemingly every celebrity has tried it. Some with wild success and others have seemingly already gained the weight back. The question everyone should be asking is what are the benefits and what are the risks?”

Click here to read more from Dr. Kalayjian

Below, read a related article from Johns Hopkins University

Weight Loss

Image by stockking on Freepix

Nearly 42% of American adults were obese from 2017 to 2020, up from roughly 30% in 2000, according to the Centers for Disease Control and Prevention. With that rise in obesity comes an increased risk for heart disease, stroke, type 2 diabetes, and some cancers.

Patients and their doctors are increasingly turning to in-demand drugs like Ozempic and Wegovy, but are they safe and effective? A recent episode of the Public Health on Call podcast explores the pros and cons with two Johns Hopkins University experts: gastroenterologist Sameer Khan of the Johns Hopkins School of Medicine and podcast host Joshua Sharfstein, vice dean for public health practice and communication engagement at the Bloomberg School of Public Health. Khan says the drugs work, but they are hard to find, expensive—around $700 a month without insurance for Wegovy which is prescribed for weight loss—and need to be taken forever to maintain weight loss and improve cardiovascular health when researchers don’t yet fully understand their long-term effects. Read on for three key takeaways from their conversation.

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How to Protect Yourself from a Wrong Way Driver

Lawrence V. Najarian, MDNote from AAHPO President Lawrence V. Najarian, MD: Recently, while driving at night on a highway, my family was almost killed by a wrong way driver. The only thing that saved my family was a reflexive understanding of the situation that I developed after reading about a fatal, wrong way driver accident that happened in our area two years ago. That understanding was critical to my reaction in the few seconds I had to grasp and respond to this situation. I would like to share information about wrong way drivers to help others who may find themselves in this dangerous situation that I thought would never happen to me.

Photo courtesy NTSB

Wrong-way driving, where a driver operates a vehicle the wrong way on a road or highway against the intended flow of traffic, can result in some of the most severe types of crashes according to the National Transportation Safety Board.

The AAA Foundation for Traffic Safety reports that despite accounting for only 3.7% of all fatal crashes on divided highways between 2010 and 2018, a high percentage of these incidents are fatal as they typically result in head-on collisions.

A study of wrong-way driving from the Iowa State University Institute for Transportation notes that wrong-way driving can occur on a variety of roadways including divided highways, freeways or arterial roads. These events are often associated with driver confusion resulting from roadways that are challenging to navigate.

Recent data from the AAA Foundation for Traffic Safety also shows a concerning rise in fatalities related to wrong-way crashes. An average of 500 deaths occurred annually from wrong-way driving crashes on divided highways between 2015 and 2018, a 34% increase from 375 deaths annually from 2010 to 2014. Wrong-way drivers made up 52.8% of fatalities from wrong-way driving crashes followed by their passengers (5.7%) and occupants of other vehicles (41.1%) between 2010 and 2018. These numbers remained elevated as roughly 500 people died in wrong-way crashes annually in 2019 and 2020, according to the Federal Highway Administration (FHWA).

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What to Do if You Encounter a Wrong Way Driver

It’s essential to take immediate and decisive actions to protect yourself and others from a wrong way driver. Here are some steps to follow if you encounter a wrong-way driver:

  1. Stay calm and focus on your own driving.
  2. Quickly assess the situation to determine the best course of action.
  3. Safely and promptly move to the right lane or shoulder, and create as much distance as possible from the wrong-way driver.
  4. Do not swerve into oncoming traffic or abruptly change lanes, as this can increase the risk of a collision with other vehicles.
  5. Obey traffic signals and signs while trying to distance yourself from the wrong-way driver.
  6. Signal and Honk:
    – Turn on your headlights and hazard lights to make yourself more visible.
    – Honk your horn to alert the wrong-way driver and other nearby motorists.
  7. Dial 911 to report the situation, and provide information about your location, the direction of travel of the wrong-way driver, and any other relevant details.
  8. Avoid confronting the wrong-way driver or attempting to block their path. Let law enforcement handle the situation.

Remember that your safety and the safety of others are the top priorities. Always use your best judgment and follow the guidance of emergency services when encountering a wrong-way driver.

Study: Hip Fracture Burden to Nearly Double Worldwide by 2050

John Bilezikian, MDNote from AAHPO Board Member John Bilezikian, MD, a renowned metabolic bone disease expert, regarding the article which appears below these remarks:

Osteoporosis, a disorder of weakened bones associated with increased risk of fracture, is a major international health problem. A recent update of the scope of this problem was recently published by Douglas Kiel, Professor at Harvard and a leader in studies related to the global epidemiology of osteoporosis. In the report recently published in the Journal of Bone and Mineral Research, the flagship journal of the American Society of Bone and Mineral Research, Dr. Kiel reports that the expected incidence of hip fracture, the most serious complication of osteoporosis, is likely to increase over the next 30 years, despite a downturn in hip fractures in many countries. The study accessed data from 19 different countries and included over 4 million hip fractures. The reason for the expected doubling in the number of hip fractures, worldwide, relates to the aging population. With aging comes increased risk of osteoporosis and fractures. Another important finding of the study confirms the point that many individuals who sustain an osteoporotic hip fracture do not received therapy to prevent another one. The risk of another fracture in someone who has sustained a hip fracture is markedly higher if treatment is not instituted. This study describes differences among countries but underscores, overall, the need for greater awareness of this disease and for implementation of measures to prevent and treat it.

Image by kjpargeter on Freepik

An international study that included researchers from Harvard Medical School indicates that while age- and sex-standardized hip fracture incidence rates have decreased in most regions around the globe, the number of hip fractures worldwide is projected to nearly double by 2050, compared to 2018.

A significant treatment gap in patients sustaining a hip fracture and not receiving therapy to prevent future fractures was also observed in all countries and regions, particularly in men.

The study, recently published in the Journal of Bone and Mineral Research, reviewed more than 4 million cases and highlights an urgent need for better strategies in hip fracture prevention and care.

Hip fracture remains a global public health concern contributing to increased dependency, morbidity, and mortality and placing a burden on patients, their families, and health care systems.

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Can Armenia’s refugee crisis catalyse health-system reform?

Editor’s note: This article is co-authored by AAHPO Board Member Kim Hekimian, PhD and AAHPO Member and MD/PhD student Christopher Marskosian, as well as Shant Shekherdimian, MD, Kent Garber, MD, MPH, and Ara Darzi, KBE, MD. The article was recently published in The Lancet, a prestigious British medical journal.

The immediate health needs of the refugees are immense. Before the exodus, people of Nagorno-Karabakh had been living under a punitive 9-month blockade, resulting in malnutrition and worsening health conditions due to scarcity of food, medicine, and vaccines. During their exile, a fuel depot explosion led to hundreds of casualties among refugees. Other factors contributing to medical needs include the suddenness of displacement, forfeiture of medical records, and loss of established longitudinal health-care providers.

But as headlines fade and humanitarian priorities shift elsewhere, Nagorno-Karabakh refugees will continue to face challenges in accessing high-quality health care. The Armenian Government intends to integrate displaced people into the health-care system, providing them with the same care as their host communities. However, Armenia has a health-care infrastructure with scarce resources and of inadequate quality. Given this reality, it would be wise for the global health response—typically focused on the acute needs of the refugees, and sometimes guilty of setting up health programming in parallel to government efforts—to simultaneously strengthen local health services towards universal health coverage, improved primary care, and optimized outcomes.

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Congratulations to AAHPO Service Award Winners: Dr. Kayayan and Dr. Barsoumanian

On Sunday, January 21, AAHPO recognized Ara Kayayan, MD and Raffi Barsoumanian, MD for their exemplary medical service to Armenians (see photos below). This was the highlight of the Winter Brunch, which was well-attended and enjoyed by AAHPO members, families and guests. CLICK HERE and scroll to the bottom of the page to see more event photos of our Winter Brunch event.

Ara Kayayan, MD, center, accepts the AAHPO Service Award from AAHPO President Lawrence V. Najarian, MD, left, and AAHPO Vice President Garbis Baydar, MD, right. Dr. Kayayan is an internist in Albany, NY who was “AAHPO’s eyes and ears” during the treatment and recovery of Bishop Mesrop, who was severely injured in 2022. Dr. Kayayan is a highly respected physician in the Albany area, and an active member of the Armenian community there.

Raffi Barsoumanian, MD, left, accepts the AAHPO Service Award from AAHPO Vice President Garbis Baydar, MD, center, and AAHPO President Lawrence V. Najarian, MD. Dr. Barsoumanian, a surgeon, was recognized for traveling to Armenia to treat soldiers who suffered severe burns in the 2020 war and required skin grafts. Dr. Barsoumanian returned to Armenia a second time to bring essential medical supplies for the treatment of soldiers.