Focusing on Flavonoids

A paper published earlier this week provides further support for the beneficial role of flavonoids in vascular health. These plant-derived chemicals with potent anti-inflammatory and anti-oxidant properties are concentrated in berries, cabbage, capers, celery seed, citrus fruits, cocoa, dark chocolate, kale, onions, oregano, parsley, pecans, radicchio, red wine, rosemary, saffron, tea and watercress. A study published earlier this year found that elderly men and women (average age, 81.2 years) who consumed the highest concentration of these phytonutrients were nearly 50% less likely to develop Alzheimer’s over the followup period (average, 6.1 years). These results build upon years of research demonstrating improvement in vascular health as reflected by reduced arterial stiffness/aging and associated lower blood pressure.

The new study assigned volunteers to receive a cup of hot cocoa that was either natural (fortified with flavonoids) or processed (devoid of flavonoids). The results were higher brain oxygen levels, more focused concentration and greater cognitive performance in those assigned to the hot cocoa drink fortified with flavonoids.

Take Home Message: Focus in on flavonoids for improved vascular health. I recommend that my patients consume flavonoid-enriched products throughout the day. This might include a handful of blueberries as part of a breakfast meal, adding some of the veggies/spices/herbs listed above for soups, salads and lunch/dinner entrees, enjoying a small amount (0.5 to 1 ounce) of dark chocolate and your favorite flavonoid-enriched beverage(s).

Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.  Check out his Top 50 Foods in his latest book:  “Heal Your Heart…” published by Penguin Random House.

The Omega-3 Fatty Acid Proven for Heart Health

One of my first experiments as a young researcher was to compare how different fatty acids were processed. After feeding 3 different types of fatty acids to human cells, an “Aha Moment!” was experienced. While 2 of the fatty acids were processed in a similar manner, the 3rd behaved very differently. Astonished by these results, I repeated the experiment only to arrive at the same conclusion. Compared to palmitate (a saturated fatty acid found in animal-based products) and oleate (a monounsaturated fatty acid found in olive oil), the omega-3 fatty acid, EPA (found in oily fish) was minimally processed into triglycerides. These experiments published nearly 3 decades ago among others, identified some of the mechanisms by which marine-derived omega-3 fatty acids (primarily EPA and DHA), reduce triglyceride levels.

Because high triglycerides increase cardiovascular risk, studies have been designed to examine whether lowering triglycerides reduces risk. While results of one of these major trials will not be forthcoming for another 1-2 years, several others have now been completed. Two of these trials used pure EPA and both demonstrated improvement in cardiovascular risk. The landmark REDUCE-IT trial found that the pure EPA formulation, Icosapent Ethyl, reduced risk by 25% while a prior trial that tested purified EPA in a Japanese population, known as the JELIS trial lowered risk by nearly 20%.

By contrast, 2 trials, STRENGTH and OMEMI, were reported and simultaneously published this past week at the Annual Scientific Sessions of the American Heart Association. Both showed that the combination of EPA and DHA did not favorably influence heart-related risk compared to the placebo group. It is important to point out that these 2 studies build upon the results of prior clinical trials that also failed to show benefit when EPA and DHA were combined.

So why is EPA effective for the heart whereas DHA is not? Even though both lower triglycerides, EPA exhibits a number of cardioprotective properties/effects whereas DHA appears to oppose some of these beneficial effects as elegantly demonstrated in a series of experiments spearheaded by my colleague, Dr. Preston Mason.

Bottom Line: EPA found in herring/salmon/sablefish (among others) and in purified form (Icosapent Ethyl) is the omega-3 fatty acid proven for heart health…and that is no fish tale!

Michael Miller, M.D., is Professor of Cardiovascular Medicine, Epidemiology and Public Health at the University of Maryland School of Medicine in Baltimore, Maryland, USA.

Are Chili Peppers the Spice of Life?

A new study presented at the American Heart Association Annual Scientific Sessions (conducted virtually in 2020), found that consuming chili peppers on a regular basis was associated with ~25% improvement in heart and overall survival when compared to non-or rare consumers of this spice. Although the study does not prove cause and effect, it extends prior observations suggesting that chili pepper may be the proverbial spice for a healthy life. Below are several reasons why you should consider adding a chili pepper (or 2) to your meals.

1. Chili Peppers burn calories: Chili peppers contain the chemical capsaicin that increases metabolism thereby promoting weight loss and reduced waist size based on a study conducted at the University of Maryland.
2. Chili Peppers reduce blood pressure: Chili peppers activate a specific family member of protein receptors (TRPs) to release the chemical nitric oxide, resulting in blood vessel relaxation and decreased blood pressure.
3. Capsaicin provides pain relief: When applied topically, capsaicin desensitizes nerves/nerve endings and provides relief for various conditions such as peripheral neuropathy. Because chronic pain increases emotional stress that in turn raises cardiac risk, pain relief is an important way to maintain good heart health.

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...” published by Penguin Random House.

Laughing Out Loud For Better Health

I don’t know about you but this has been one very long and seemingly unending week! No matter your political persuasion, stress levels have been quite high. But the good news as I recently told the New York Times, is that laughter counteracts the adverse effects of stress on your heart and overall health.

My interest in the science of laughter dates back to the 1990s. While it was known that emotional stress could adversely affect your heart and blood vessels, no studies had examined whether positive emotions would have an opposing effect. To investigate this question, we first examined how men and women responded to certain situations in daily life. For example, if you were at a (pre-COVID) party and someone was wearing the same outfit, how would you respond? As it turned out, those with heart related issues were ~40% less likely to find this situation (and a bunch of others) amusing compared to healthy volunteers. Of course, these results do not prove cause and effect. In other words, were those predisposed to poor heart health be less likely to find humorous situations to be funny or did comical situations become less comical after a cardiac event occurred. We then conducted a more direct test by examining blood vessels in response to emotions. Experiment after experiment showed that blood vessels contracted in response to a movie that produced emotional stress whereas blood vessels expanded in response to watching a movie that produced laughter. The chemical that causes blood vessels to dilate in response to laughter is nitric oxide- a heart protective chemical that lowers blood pressure, reduces blood clots, lowers inflammation and inhibits cholesterol plaque buildup in arteries.

Click on the following 3 links for a good laugh (and to release nitric oxide)!

1. Voices for Strays
2. Ready: 1,2,3 catch!
3. Baby Laughing

Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.  For a lot more information on improving your heart health, check out his latest book:  “Heal Your Heart: The Positive Emotions Prescription to Prevent and Reverse Heart Disease“ published by Penguin Random House.