30 Years of Heart-Related Discoveries/Advances at the University of Maryland School of Medicine

As my 30-plus years as a faculty member at the University of Maryland School of Medicine and Medical Center has drawn to a close, I fondly recall 10 heart-related findings/discoveries and newsworthy events that gained worldwide attention, ending with the first genetically altered pig heart transplanted at UMMS last week.  Here they are in no special order.

1.         Poe likely died of rabies, doctor’s review shows: https://www.baltimoresun.com/news/bs-xpm-1996-09-11-1996255015-story.html

2.         Having high cholesterol levels early in life leads to heart problems by middle age: https://www.eurekalert.org/news-releases/823756

3.         Air Pollution and Diabetes: https://www.loe.org/shows/segments.html?programID=14-P13-00002&segmentID=5#:~:text=We’ve%20long%20known%20that,fatty%20diet%20can%20promote%20diabetes.

4. U.S. Amish gene trait may inspire heart protection: https://www.reuters.com/article/us-heart-gene/u-s-amish-gene-trait-may-inspire-heart-protection-idUKTRE4BA6JQ20081211

https://www.loe.org/shows/segments.html?programID=14-P13-00002&segmentID=5

5.         Want a McMuffin? Take your McVitamins: https://greensboro.com/want-a-mcmuffin-take-your-mcvitamins/article_20be3661-d342-549f-9118-a2e355f4175a.html

6.         UMMC Implants the World’s Smallest Pacemaker: https://www.umms.org/ummc/news/2017/ummc-implants-the-worlds-smallest-pacemaker

7.         University Of Maryland School of Medicine Study Shows Laughter Helps Blood Vessels Function Better: https://www.sciencedaily.com/releases/2005/03/050309111444.htm

8.         Study finds no value in heart supplement: CoQ10 not shown to relieve symptoms, UM cardiologist says: https://www.baltimoresun.com/news/bs-xpm-1999-09-27-9909270293-story.html

9.         Secondhand Smoke Ups Heart Disease in Unique Group of Female Nonsmokers – Amish Women: https://www.umms.org/ummc/news/2017/amish-secondhand-smoke

10.       In a First, Man Receives a Heart from a Genetically Altered Pig https://www.nytimes.com/2022/01/10/health/heart-transplant-pig-bennett.html?smtyp=cur&smid=tw-nytimes

Dr. Michael Miller is Chief of Medicine, Corporal Michael J Crescenz VAMC in Philadelphia, PA   Check him out on twitter: @mmillermd1

Natural Foods to Combat Depression During the Holiday Season

While the holiday season is jovial and celebratory for the majority of Americans, it can also be a source of despondency and despair for others. This is especially true for those afflicted with seasonal affective disorder or have great fear and anxiety leading to self-imposed travel restrictions in the midst of the COVID pandemic.

Fortunately, as of this writing, the most recent evidence suggests that if you’ve been vaccinated and “boosted”, the latter should be less of an overriding concern.

Nevertheless, as compared to the pre-COVID pandemic era, levels of depression and anxiety have also risen to unforseen heights.  With the Holiday Season upon us, presented below is a heart healthy selection of foods/drinks proven to enhance mood and combat/limit depression and make your holiday season a more enjoyable one.

1. Mushrooms: A new study of nearly 25,000 men and women found that compared to non-consumers, those who ate mushrooms on a regular basis were less likely to experience signs of depression.  Mushrooms are an excellent source of ergothioneine (ERGO), an amino acid with antioxidant properties shown (in rodent studies) to alleviate symptoms of depression.  Other good food sources of ERGO are beans (black, kidney) and oat bran.
2. Cranberries:  Cranberries are also rich in antioxidants and in 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, especially anxiety and depression. Try a handful of cranberries or 4 ounces of pure cranberry juice each day to reap the benefits.
3. Prebiotics: Non-digestible carbohydrate foods (prebiotics) such as garlic, Jerusalem artichokes, leeks and onions, promote the growth of healthy gut bacteria to reduce neuroinflammation and improve symptoms of anxiety and depression.
4. Dark chocolate: A study of ~13,600 adults found that compared to non-consumers, daily consumption of dark chocolate (3.5 ounces) was associated with ~60% lower risk of depression.
5. Coffee: Compared to minimal or no consumption, coffee drinkers have a 25% lower risk of depression. The most favorable results were observed with an average amount of 13.5 ounces consumed daily.
6. Mediterranean Style Diet: A Mediterranean style diet (vegetables, fruits, legumes, nuts, whole grains, fish) is associated with improved mental health in men and women with depression.
7. Kiwi: A recent study found that consuming a kiwifruit daily was associated with improved mood and overall well-being that was attributable to more than the high Vitamin C content.
8. Bivalves: Mussels, oysters, clams and scallops are good/excellent sources of selenium associated with reduced depression and improved mood.
9. Bananas: Bananas are an excellent source of Vitamin B6 with anti-anxiety, antidepressant properties. A banana a day may keep the psychiatrist away!
10. Pumpkin Seeds: Try a small handful of pumpkin seeds daily. The rich content of tryptophan, zinc and magnesium may reduce anxiety and combat depression.

Dr. Michael Miller is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland.  Check him out on twitter: @mmillermd1

Does a High Fat Diet Promote Memory Loss and Cognitive Decline?

A new study out this week and published in iScience found that fat cells play a major role in advancing brain aging and cognitive decline through Na,K+ATPase signaling.  Recent studies have suggested that this pathway is also responsible for conditions that accelerate cardiovascular disease risk including, metabolic syndrome and fatty liver (nonalcoholic steatohepatitis).

The new study was conducted in mice that were genetically modified to release the peptide, NaKtide, in fat cells.  NaKtide is a direct inhibitor of Na,K+ATPase signaling.  The authors found that compared to a control diet, a Western diet (greater than 40% of calories derived from fat) resulted in Na,K+ATPase -mediated cellular inflammation and altered levels of brain biomarkers that affect memory and cognition. These proinflammatory effects were abolished when NaKtide was activated, thereby resulting in improved function of regions that include the brain’s memory center (hippocampus).

The bottom line is that in a mouse model, Na,K+ATPase signaling in fat cells promotes memory loss and neurodegenerative changes.  They raise the possibility that a similarly operative signaling -pathway in humans might lead to adverse long-term neurologic consequences under certain conditions (such as repeated exposure to a high fat diet).  Finally, they suggest that effective therapies directed against this proinflammatory signaling pathway could offset cognitive decline.

Of course, the most effective and currently available approach to reduce cognitive decline as related to this pathway would consist of reducing daily intake of highly saturated, processed and deep-fried foods!

Listed below are additional features related to diet, physical activity, obesity and brain health.

1. Obesity promotes inflammation within the brain leading to cognitive decline and progression of neurodegenerative disorders.
2. Significant and rapid weight loss as a consequence of bariatric surgery has been associated with improvements in cognitive function including memory and executive function.
3. Adherence to the Mediterranean diet – high in vegetables, whole grains, fish, and olive oil – correlates with higher cognitive function.
4. Compared to a high fat, Atkins Diet, a low fat Ornish Diet is associated with low levels of TMAO, a gut metabolite predictive of increased cardiovascular disease risk and reduced cognitive function.
5. Replacement of saturated fat by polyunsaturated or monounsaturated fat is associated with lower rates of neurodegenerative disease.
6. Higher levels of physical activity are associated with a 35% reduced risk of cognitive decline and 14% reduced risk of dementia.
7. A diet containing at least one serving of green leafy vegetables each day is associated with slower age-related cognitive decline by approximately 10 years.
8. Metabolic Syndrome is associated with increased risk of developing cognitive impairment and premature dementia.
9. Chronic exposure to stress confers a higher risk of developing neurodegenerative disorders including Alzheimer’s disease.
10. Chronic insomnia is associated with a 30-35% increased risk of progressive dementia.
11. Musicians are 64% less likely to develop mild cognitive impairment or dementia, even after adjusting for physical activity and education.
12. Drinking 3-5 cups of coffee per day at midlife was associated with a decreased risk of dementia and Alzheimer’s Disease by about 65% at late-life.
13. Speaking at least 2 languages has been shown to delay the onset of dementia by 4-5 years.

Dr. Michael Miller is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland.  Check him out on twitter: @mmillermd1