3 Spices to Spruce up the Holiday Season

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During the holiday season we tend to overindulge on a variety of foods that are not the healthiest for our hearts.  But the good news is that certain spices popular during the holiday season can also keep your heart healthy and boost your spirits.  Here are several spices that are a definite win-win and guaranteed to spruce up your holiday season.

  1. Cloves: Clove oil is among the best natural sources containing eugenol, a powerful anti-inflammatory and antioxidant compound.  Studies have found administration of clove oil to reduce cholesterol, triglycerides and excessive fat in the liver and to inhibit blood clot formation, A small, unpublished study in diabetics also found that as little as 1 gram of cloves a day (~12 clove pieces) for 1 month was associated with decreases in glucose, cholesterol and triglycerides.  And if you don’t like cloves, you can use it as a natural repellent for ants (who detest the scent).
  2. Cinnamon: Studies in diabetics have found that consuming cassia extract, capsules or raw powder (~1 teaspoon daily) produced meaningful reductions in glucose, cholesterol and triglyceride levels.  Check out our recent review paper for more details.
  3. Nutmeg:  Used in popular sauces, pies and holiday drinks (e.g., eggnog), this aromatic spice can promote a “Jekyl & Hyde” response. That is, in small amounts (pinch to 1/4 teaspoon) nutmeg has a calming effect and when added to a glass of warm milk ~2 hours before bedtime can lead to a more restful sleep.  However, at high doses (~2 tablespoons), nutmeg can produce toxic effects, including heightened anxiety and hallucinations.  In other words, just a “little dab will do you”…enjoy!
  4. Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.  His book:  “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease” focuses on natural ways to improve your heart and emotional health.

Is Intermittent Fasting Right For You?

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Years before it became fashionable, I recommended to my patients interested in optimizing their heart health not only to eat their last meal at least 4 hours prior to bedtime but to also keep their dinner meal light (for more details see  “Heal Your Heart…” below).

As a researcher involved in numerous fat-feeding studies, it is well established that after we eat a meal containing fat, our triglycerides levels (blood fats) not only increase but can spike upwards of 2-3 fold with peak levels occurring ~4 hours after the meal.   Similarly, consuming carbs leads to a rapid rise in blood glucose and insulin levels that taper down over the next several hours (in the absence of insulin resistance).  The rise in blood glucose levels tend to be slower after consuming complex carbs contained in dietary fiber than in processed and refined carbs found in soft drinks (soda) and candy. However, if you keep your dinner meal light and engage in mild physical activities (such as an after dinner walk), you will boost your metabolism by revving up proteins involved in digesting fats and carbs thereby maintaining triglyceride, glucose and insulin levels under better control.  Left untreated, high levels of blood fats, glucose and insulin promote weight gain, insulin resistance, hypertension, diabetes as well as raise the risk of a heart attack and stroke.

It turns out that intermittent fasting (IF) can also help to boost metabolic (and vascular health) because increasing the number of hours in the fasting state reduces weight, blood pressure and blood levels of triglycerides, glucose and insulin.  For example, in a recent study of men at increased risk of diabetes, eating for 6-hours a day improved insulin sensitivity and blood pressure without increasing the urge to eat.  Keep in mind that a 6-hr time window for eating may be quite difficult especially if you work long hours; my most successful patients adhering to this regimen also have more flexible schedules. That is, they generally eat breakfast ~10 AM and conclude their dinner meal ~4 PM with weight loss in the 10-20 lb range (and in some cases more than 25 lbs).  Because IF represents a lifestyle change rather than a fad diet, weight loss can be sustained for years.  While many of my patients have found 6-hour IF to be too restrictive, they are able to maintain an 8 and especially 10 hour eating period (e.g., ~8 AM- 6PM) daily.  Whatever IF approach you decide on, the majority of calories should be consumed during breakfast-lunch followed by a light dinner with no snacking afterwards.

In addition to weight loss, my successful IF patients tell me they sleep better, have more energy, are happier and more productive.  Even though it can be very effective, make sure to speak to your physician and determine whether IF is an appropriate lifestyle consideration for you.

Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.  His book:  “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease” focuses on natural ways to improve your heart and emotional health.

 

 

 

 

4 Health Benefits of Mushrooms

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Mushrooms may be among the most underrated superfoods, but make no mistake, they possess a veritable boatload of vital nutrients and properties guaranteed to enrich your heart, spirit and overall health. Whether they are cultivated or obtained in the wild (such as the yellowfoot mushrooms illustrated above), listed below are 5 reasons why I avidly endorse the consumption of these edible delicacies on a daily basis.

  1. Antioxidant Powerhouse: Edible mushrooms are an excellent source of antioxidants such as polyphenols (e.g., flavanoids), polysaccharides (e.g., beta-glycan) and vitamins (e.g., C and E) that help to neutralize free radicals from promoting cell damage, cancers and age-related diseases of the heart and brain. Consumption of edible mushrooms as part of a healthy lifestyle prescription may help to maintain and improve quality of life.
  2. Lowers Blood Pressure: Eritadenine is a compound isolated from shitake and other mushrooms that inhibits ACE (angiotensin-converting enzyme). ACE inhibitors are medications that are commonly used to treat elevated blood pressure.  in addition, mushrooms are a good source of dietary potassium, thereby providing another avenue to help reduce high blood pressure.
  3. May Reduce Weight: Have you heard of the mushroom diet?  If you are looking to shed some weight, try substituting portobello mushrooms for red meat and you may lose 5-10 pounds!
  4. Reduces Depression and Anxiety: Consuming the edible mushroom, “Lion’s Mane” has been shown to alleviate symptoms of depression and anxiety.  This should not be confused with psilocybin, another compound isolated from mushrooms that may elicit hallucinogenic behavior and result in panic attacks.
  5. Michael Miller, MD is a Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.  His book, “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease” focuses on proven methods to manage stress and improve cardiovascular health.

Reflections on the REDUCE-IT™ Study

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Among the highlights of this year’s American Heart Association meeting in Chicago was the REDUCE-IT Study, masterfully presented by my colleague, Dr. Deepak Bhatt and simultaneously published in the New England Journal of Medicine. The study examined the use of a highly concentrated and purified form of EPA, icosapent ethyl, in more than 8,000 men and women with high triglycerides and either cardiovascular disease or high-risk patients with diabetes.

We’ve known for many years that having high levels of LDL (the bad cholesterol) promotes heart disease and effective therapies such as statins, reduce rates of heart attacks and strokes.   And while high triglycerides also increase the likelihood of adverse heart-related outcomes, garnering support to conduct a large clinical trial aimed at studying men and women with elevated triglyceride levels was lacking. Elevated triglycerides are common in the U.S. and other westernized societies; approximately ~1 in 3 adults have triglyceride levels above 150 and ~1 in 5 have levels above 200 mg/dL.

After several large pharma companies passed on supporting such a study in men and women with heart disease and high triglycerides, the small Irish biopharma company, Amarin stepped up to the plate… the end result is the REDUCE-IT study.

Men and women assigned to the active treatment arm received 4 grams of icosapent ethyl daily. EPA is found in oily fish, such as sardines, salmon, herring and mackerel, but if you believe you can consume that amount in 1 serving of these fish, think again. With a single 3.5 ounce (100 gram) serving of salmon, the amount of EPA approximates ~0.7 grams.   In other words, you would need to consume ~20 ounces (570 grams) of salmon each day to get the amount obtained with 4 grams icosapent ethyl!

To quote some of my colleagues, the results of REDUCE-IT were “unprecedented”, “game changer”, “sea change”, et cetera, because of the magnitude in the reductions of heart attacks, strokes and cardiovascular death compared to other contemporary lipid trials. In part, this reflects the fact that clinical trials that study patients with heart disease must utilize standard-of-care therapies. This would include statins, where cardiovascular risk is reduced by 25-35%. Consequently, it has been very difficult to show additional benefit on the background of statin therapy. Not surprisingly, early studies failed and it wasn’t until the past decade when more effective therapies (ezetimibe, PCSK9i) were able to show significant lowering of events in the range of 6-15%. Now contrast that with REDUCE-IT, where a more robust 25% decrease in heart attacks and strokes was observed as well as a 20% reduction in cardiovascular death. Importantly, REDUCE-IT is the first lipid-based study to show improvement in cardiovascular death on the background of statin therapy.

BOTTOM LINE: We finally have a safe and effective therapy to treat men and women with heart disease, diabetes and high triglycerides.

Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.  He served on the Steering Committee for the REDUCE IT trial.

Open Sesame: Several Surprising Benefits of Seeds

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Seeds are such a vital powerhouse of heart healthy and mood boosting nutrients that I recommend my patients consume up to a handful of their favorite seeds daily.  As illustrated, sesame, flax, pumpkin and sunflower seeds lower cholesterol, triglycerides (blood fats) and regulate glucose levels.  As excellent sources of magnesium, Vitamins B6, folate and zinc, seeds may also trigger the release of neurotransmitters to uplift mood. In fact, daily seed consumption is among the dietary cornerstones for prevention of depression.

Chia seeds may also effectively curb appetite- try soaking 1 teaspoon over a 10 minute period in a glass of water, then drink the water 20-30 minutes before your main meal and you may be pleasantly surprised by the results.

Certain seeds contain lignans, plant compounds rich in (polyphenol) antioxidants. Flaxseed and sesame are superb sources of lignans; recent studies support an anticancer role for sesame seeds.  Flaxseed has also been shown to reduce growth of breast cancer cells.

To get a “double-bonus” try a small handful of seeds covered in dark chocolate.  One of my favorite snack recommendations is dark chocolate covered pumpkin seeds (illustrated).  Keep in mind that just small amounts such as 1/2 handful is sufficient to boost mood by releasing the positive emotion neurotransmitters, serotonin and anandamide.   Each handful of seeds (without chocolate) will cost you ~200 calories, so plan not to exceed this amount in order to reap the health benefits.

Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.  His latest book is  “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease“.

 

St Louis: A Great City & Storied Baseball Team

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St Louis is a great American city filled with midwestern charm and youthful energy. The Cathedral Basilica (a portion of which is shown in the first frame) is one of America’s most beautiful Catholic churches and the Gateway Arch, the world’s tallest stainless steel monument (height=width), represents U.S. expansion from East to West.  St. Louis is also home to Washington University (WashU),  one of America’s premier institutions of higher learning.

As I watch the 2018 World Series, I can’t help but reminisce about one of baseball’s most storied franchises, the St. Louis Cardinals.  After all, the redbirds (not the Dodgers or the Red Sox) are second only to the Yankees in winning the most World Series championships.  And among the greatest Cardinals to ever play the game (my all-time favorite) was 3rd baseman Ken Boyer. His clutch grand slam home run in the 1964 World Series turned the tide in favor of St. Louis as the Cardinals upended the Yankees (and their all-star trio of Mantle, Maris and Ford). Check out the recent book on Ken Boyer that provides a compelling argument in support of Boyer’s induction into Baseball’s Hall of Fame.

Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.

 

Why Certain Supplements are Hard to Swallow

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Dietary supplements are a multibillion dollar industry that for many years have been promoted to improve your health.  After all, why wouldn’t you want to take a vitamin that is “guaranteed” to boost mood, energy and vitality, while reducing all types of maladies?  Companies supporting these products have convincingly sold the public that unproven supplements are the “be-all-end-all” and it is not uncommon for a patient to rely on supplements rather than proven remedies for treating a variety of ailments,

Listed below are several reasons why you should be skeptical with regard to the use dietary supplements and why their use is hard to swallow.

  1. Supplements may contain toxic compounds.  Believe it or not, dietary supplements are considered as a category of food and considered “safe until proven otherwise”.  This is vastly different from OTC (over the counter) pills that are strictly regulated by the Food and Drug Administration.   In other words, if you purchase an OTC product like ibuprofen 200 mg, you will receive ibuprofen 200 mg. But if you purchase a supplement, you may be receiving more than you bargained for. In fact, a large study found that supplements can contain toxic heavy metals such as arsenic, mercury and lead.
  2. Supplements are not proven to benefit health. Vitamin supplements, that have tested Vitamins A, B, C and E have failed in large clinical trials to reduce the risk of heart disease or malignancy.   Even Vitamin D supplements have not been shown to improve bone health. And what about those omega-3 and krill capsules that have been heavily promoted?  Well once again, there is no evidence that these supplements work either! 
  3. Some supplements may cause more harm than good:  Vitamin A supplements have been linked to increased risk of cancer as have herbal supplements containing  guang fang ji.
  4. Supplements are a waste of money:  Supplements are expensive, unregulated and unproven, so why take them?  Well, the one exception would be if you are deficient in a specific vitamin, such as vitamin B12 or D that cannot be adequately driven up through dietary sources.  In these instances, it is reasonable to take the supplement to raise levels to normal and avoid the potential problems associated with low levels. However, if your levels are within the normal range, then no proven benefit exists.  Nevertheless, because taking a vitamin sounds better than taking a medication, I tell my patients to consider their medications as their “vitamins”.  This is a win-win because vitamins sound better but medications work better.  
  5.   Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.  His book:  “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease” focuses on natural ways to improve health without supplements!

WWII Heroes, Poker & Life Lessons

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Over the past several years, Monday nights have become a favorite of mine as we gather together at a neighbor’s house to play poker.  Now, if I am going to lose on a regular basis, I couldn’t think of more deserving men to give away my hard earned cash than to 4 heroes: 3 World War II Veterans and retired police officer.  As pictured from left to right, Mel: a former Marine who fought in the Battle of Okinawa,  Bruce: who served to protect the citizens of Baltimore during his years on patrol,  Carmen: who won a Purple Heart for his bravery during the Battle of Anzio, and Rene: who fought in the Battle of Dunkirk, (the subject of a recent motion picture). 

Below are several observations learned in my poker games with these heroes.

  1. Heroes don’t talk about themselves & shy away from the spotlight.   (During poker games, it took a lot of prodding for each of these men to talk about their heroic acts).
  2. Heroes are brutally honest.  (Each of these players ensures that the game is played above board and no cheating occurs).
  3. Heroes are kind & empathetic. (When I customarily “lose my shirt” after playing poker, these heroes are genuinely kind and offer solace & comfort).
  4. Heroes have incredible poker faces. (That’s probably why I always lose)!     Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.  He has conducted numerous research studies aimed at improving heart health and covered in his book:  “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease“.

 

Why PETS Are Great For Your Heart

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The expression, “a dog is a man’s (& girl’s) best friend” is especially meaningful when it comes to heart health.  Studies conducted in recent years have reinforced the concept that pets in general (and dogs in particular) impact major risk factors affecting cardiovascular health.  Listed below are several reasons why you should consider owning a pet (if you don’t already have one).

  1. Hugging your pet releases oxytocin.  As shown in the picture taken of my son and pet cockapoo, when he was just a puppy.  Oxytocin acts as an anti-stress hormone that not only boosts mood but also possesses blood pressure and heart rate lowering properties and may even assist in the regeneration of damaged heart cells.
  2. Owning a dog lowers cholesterol & triglyceride levels.  Increased activity levels through walking, jogging and playing with your dog can help to reduce levels of cholesterol and triglycerides.   In addition to LDL (the bad cholesterol), high levels of blood triglycerides (especially above 200 mg/dL or 2.3 mmol/L) have become increasingly recognized as an important contributor to adverse heart health.
  3. Stress reducing properties of pet ownership improves survival. Beyond increased physical activity levels and touching/hugging your pet, owning dogs or cats is associated with reduced risk of stroke. 
  4. Improves recovery time after illness. After a serious illness, having a pet helps to improve overall recovery time.  This may be particularly important if the person who is recovering has otherwise limited emotional support.
  5. Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.  His pet dog “George Herman” is 10 years old and continues to learn new tricks!  Dr. Miller discusses other ways to boost heart health in his highly acclaimed book  “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease“.

5 Fall Foods to Brighten Your Mood

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This past February I wrote about 5 foods to brighten one’s mood during the dead of winter! Now as we head into the colorful fall season, I thought it would be similarly appropriate to present fall foods that uplift your health, mood and spirits.

Here are 5 of my favorites:

  1. Pumpkin Seeds:  As a rich source of magnesium, tryptophan and zinc, 1  handful each day is a superb snack to help calm daily stressors and elevate your mood.
  2. Butternut Squash: Try 1/2 cup servings at least once weekly for a rich supply of heart healthy and mood boosting minerals and vitamins; they include potassium, manganese, vitamins A, E and B6.
  3. Parsnips: A less colorful cousin of the carrot, parsnips are low in calories, high in fiber, manganese and the mood boosting vitamin folate. Parsnips are delicious in soups or as a side dish, especially when combined with carrots. Try steaming or roasting 1/2 cup (approximately 2 medium parsnips) at least once a week during the upcoming months as part of a savory autumn meal.
  4. Sweet Potatoes: Ranked as the #1 food source of vitamin A, sweet potatoes are loaded with antioxidants, folate and vitamin B6.  Enjoy at least 1 sweet potato each week (and raise your spirits) during the fall season .
  5. Cranberries:  Cranberries are also rich in antioxidants as well as the brain protective and anti-inflammatory compound ursolic acid.  Ursolic acid not only reduces growth of certain tumors but has also been shown to improve memory and reduce mood disorders, notably anxiety and depression.  Try a handful of fresh or dried cranberries at least once each week and reap the benefits!                                   Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.  His latest book is  “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease“.