A Memorable Discovery for Dementia?

Alzheimer's Disease, Brain Health, Fitness, Nutrition, sleep

Having recently celebrated my 30th anniversary at the University of Maryland School of Medicine and upon hearing the Beatle’s tune, “In My Life”, I was struck by the verse “and these memories lose their meaning”.  Though highly unlikely that John (Lennon) wrote this verse with “dementia” in mind, the words can certainly be consistent with memory loss.

Yet while tremendous strides have unfolded in treating cardiovascular disease (heart attacks, strokes, etc) in recent decades, the pace of progress has been slower when it comes to prevention/treatment of Alzheimer’s disease and other forms of dementia.  The initial exhuberance following FDA’s approval of Biogen’s Alzheimer’s disease drug, (aducanumab or  “Aduhelm”) last month, despite mixed study results, was met with immediate skepticism and calls for a federal investigation as to whether there was sufficient justification to warrant approval.   Undoubtedly, stakes are high with an estimated 6.2 million Americans (~1 in 9) aged 65 and older having some form of dementia.

However, hope may be on the horizon as a new study out this week sheds important insights into how memory loss may be reversed.  The study conducted in the United Kingdom examined PNNs (perineuronal nets), highly specialized structures involved in regulating neuroplasticity (the way the adaptive brain learns and develops new memories).  In early childhood, there is increased neuroplasticity but as the brain ages, PNNs decrease and neuroplasticity wanes. An important compound in PNNs that promotes neuroplasticity is chondroitin-6-sulfate (C6S).  The new study found that administration of C6S to aged mice restored their ability to quickly recognize objects at levels similarly observed in younger mice.

Bottom Line: while more animal studies are required to confirm the effects of C6S on memory before progressing to human trials, the new study may turn out to be a memorable discovery for dementia.

In the meantime, listed below are lifestyle related tools that may help sharpen your memory:

  1. Reduce Sugary Beverages: Drinking more than 1 sugared beverage (soda, juice) daily was associated with reduced memory and lower brain volume compared to minimal or no sugary beverage intake.
  2. Add Blueberries: 1 cup of fresh blueberries daily is associated with fewer learning errors and improved cognition in men and women aged 60 years and older.
  3. Practice MindBody Exercises: Participating in mind-body exercises such as Tai Chi, yoga and dancing mindfulness movements improve learning, memory and adaptable brain responses (neuroplasticity). 
  4. Aerobic Activity: Moderate aerobic activity (walking at a pace of 3-5 mph) was shown to improve cerebral blood flow and cognitive function in men and women with mild cognitive impairment over a 12-month period.
  5. Sneak in an Afternoon Nap: Power napping for as little as 30 minutes in the afternoon is associated with improved memory and cognitive function.
  6. Stay Hydrated: Dehydration is associated with impaired cognitive function. Drinking  6 ounces of water each hour over a 10 hour period will help keep your mind sharp.

Dr. Michael Miller is Professor of Medicine at the University of Maryland School of Medicine.

Lift Weights to Lose Weight

cholesterol, Diabetes, Fitness, Health & Wellness, Heart Health, obesity, resistance training, smoking, weight lifting


A new study shows that lifting weights/resistance training 2 or more days a week for as little as 30 minutes per session is associated with or a 20-30% lower risk of developing obesity over a 6 year period. In addition to traditional weight machines and free weights, muscle strengthening/tone activities include full body squats, pushups, planks and other core exercises.

This study adds to the growing evidence that muscle toning exercises are cardioprotective.  Among the first studies to demonstrate heart protection was the “Harvard Health Professionals’ Follow-Up Study, which found that weight training for at least 30 minutes each week resulted in a 23% lower risk of a heart attack or death from heart disease**

Shown below are several other reasons why weight/resistance training aimed at muscle toning should be part of your overall physical fitness prescription to improve cardiometabolic health by reducing the following:

  1. Type 2 diabetes: A study of nearly 4700 adults found that moderate weight training that resulted in increases in muscle mass (assessed by bench and leg press) reduced the risk of developing Type 2 diabetes by 32% over an 8-year period.
  2. Conversion from Pre-diabetes to Type 2 diabetes: Another study of men and women with prediabetes (fasting glucose between 100-125 mg/dL) found resistance training (1 hour thrice weekly) to reduce conversion to Type 2 diabetes by 65%!
  3. High Cholesterol: A Study of more than 7300 men found that ~1 hour of resistance training per week was associated with a 32% lower risk of high cholesterol (equal to or greater than 240 mg/dL) over ~20 years of followup.
  4. Quitting Smoking: A study funded by the National Cancer Institute found that men and women who engaged in two 1-hour sessions of resistance training over a 12-week smoking cessation program were 2x as likely to successfully quit than their non- weight lifting counterparts.

Dr. Michael Miller is Director, Center for Preventive Cardiology at the University of Maryland Medical Center in Baltimore.

**from Heal Your Heart: The Positive Emotions Prescription to Prevent and Reverse Heart Disease”

The Single Best Exercise You’ve Probably Never Tried…but need to in 2020!

Fitness, Health & Wellness


Walking backwards also known as Retro-walking is one of the simplest and healthiest exercises you’ve probably never tried!  Below are 5 good reasons to incorporate this exercise into your daily routine.  


  1. Improves muscle strength: Walking backwards increases muscle strength of your thighs (quadriceps) and calves as well reducing wear-and-tear on knee ligaments (anterior cruciate).
  2. Increases balance and coordination. Walking backwards not only improves balance in otherwise healthy adults (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4932084/) but also speeds up rehabilitation after a stroke (see https://www.ncbi.nlm.nih.gov/pubmed/29232308)
  3. Reduces Body Fat: Walking backwards requires more energy in a shorter period of time than walking forward. As a result, ~30% more calories are burned and body fat is reduced (see https://www.ncbi.nlm.nih.gov/pubmed/15776337).
  4. Reduces Back Pain: When you walk backwards your posture improves because greater concentration is required compared to conventional walking.  This produces a taller stature and lengthening of the hip flexor muscles which in turn ease low back pain that is often accompanied by poor posture and tightness of the hip flexors.
  5. Improves Brain Function: Walking backwards has been shown to improve various brain functions including attention span, memory and processing speed as assessed by the Stroop Test (see https://journals.sagepub.com/doi/full/10.1111/j.1467-9280.2009.02342.x?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed)
  6. I tell my patients to find the longest room in their home and to start by simply walking forward and backward for 5 minutes on day 1 and progress to 10-15 minutes daily. Other places to safely walk backwards on a flat surface include a nearby school playground or track. Doing this exercise at least 4 days a week on a regular basis will reap important health dividends for your heart, body and mind.  So start 2020 on more than just the “right foot”…move both feet backwards!
  7. Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland  and author of Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease” published by Penguin Random House.

Tango Your Way To Heart Health

Fitness, Heart Health


Among the highlights during our recent trip to South America, was the colorful neighborhood of Caminito, where dancers tango down the streets of beautiful Buenos Aires.    As it turns out, dancing is one of the heart healthiest activities we can engage in.

Here are 3 reasons why you should dance as part of a lifestyle prescription for good overall health.

  1. Dancing Keeps You Mentally Sharp:  Movement rich activities such as dancing helps to keep our brains young and vibrant by forming new connections.In fact, dancing may also slow the development of neurodegenerative disorders such as Alzheimer’s.
  2. Dancing Reduces Heart Related Death: A large study found that moderate intensity dancing (as in doing the Tango) was associated with an approximate 50% lower risk of dying of a heart attack or stroke.
  3. Tango Dancing Improves Socialization Skills and Emotional Health:  A survey of Tango dancers not only found superior physical health but also superb communication and socialization skills as well as emotional health and stability.                                                                                                                                                    Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.   His most recent book, Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease” is based on original research.  

5 Health Benefits of Yoga

Fitness, Heart Health

lisa yoga poselisa and george yoga

As pink cherry blossoms snowed down on a delightfully cool and windy April morning, my wife Lisa took advantage of the majestic scenery to practice some yoga poses.  Even our Cockapoo, George got into the picture!

But as it turns out, yoga can be of great benefit to your heart and overall well-being. Here are 5 good reasons:

  1. Yoga reduces blood pressure: A large recent analysis of 49 trials found that when yoga was practiced 3 times each week for 1 hour, blood pressure levels fell by an average of 11 mmHg in systolic (top number) and 6 mm Hg in diastolic (bottom number) over a 3 month period.  In each 60 min session, approximately 30 minutes was spent on physical postures, 15 min on breathing techniques and 15 min on mediation and relaxation exercises.  This blood pressure lowering benefit is equivalent to being prescribed a blood pressure medication!
  2. Yoga reduces inflammation:  Another review found that the equivalent of practicing yoga for 16 hours (such as 2 sessions a week for 1 hour over a 2-month period) reduces inflammation commonly associated with chronic medical conditions.
  3. Yoga improves heart-rate variability:  Heart-rate variability tests the ability of your heart to adapt to and respond to stress (both mental and physiologic).  For example, after a heart-based stress test, a healthy heart reverts quickly from the fast heart rate induced during the test to normal levels during recovery.  By improving  heart-rate variability, yoga practitioners have hearts that are well conditioned and more readily adaptable  to daily stressors.
  4. Yoga improves balance and stability:  A number of studies have demonstrated improvement in balance and stability that would be particularly important in older men and women.  In fact, yoga has been shown to reduce the risk of falling in those with physical and other age-related impairments.
  5. Yoga reduces stress:  Yoga reduces blood levels of stress hormones such as cortisol and may help those living with anxiety and stress.   If you’ve never tried yoga, now is the time to do it as benefits apply to anyone and everyone interested in good health and well-being.
  6. Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland  and author of Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease” published by Penguin Random House.








How Much Exercise Do You Need?



While exercise plays an important role for maintaining good health, one question that my patients commonly ask is how much exercise they need to reap cardiovascular benefits.  It turns out that you do not need to run marathons or engage in rigorous activities to derive the advantages.  What is most important is to be active; walking is arguably the easiest and most available activity to keep your heart young and healthy while limiting wear-and-tear of your joints (knees and hips).

Listed below are several useful tips related to physical activity that I recommend to my patients interested in keeping their hearts young (and keeping them young at heart).

  1. Aim to walk approximately 5 miles a day:  Keep track of your daily activities using a pedometer or similar tracking device (iphones have a built-in “health app” that automatically tracks your daily activities).  Every 2,000 steps equals 1mile; 10,000 steps is equivalent to 5 miles.
  2. Walking burns calories: If you weigh between 100-200 pounds, you can expect to burn 250-500 calories simply by walking 5 miles each day.  Because 3500 calories is equal to 1 pound, adding 5 miles a day will result in weight loss (provided of course that you don’t increase food intake).
  3. Aim for a walking rate of 3-5 miles per hour (mph):  When it comes to heart health, the sweet spot is walking at a “brisk” rate of 3 to 5 mph.  If you are walking on a treadmill, start off with a 5-10 minute warmup period (2-3 mph), then engage in the higher walking rate for 20-30 minutes followed by a 5-10 minute cool down period.
  4. Arise and stretch every 20-30 minutes at work: If you have a sedentary job where you are assigned to a desk/computer, stand and stretch at least twice each hour.
  5. Build in light weight toning and stretching exercises:  A healthy physical activity regimen should incorporate light weights and stretching to stabilize and improve balance & coordination in order to lower fall risk.  Engaging in aerobic activities and weight toning exercises, lowers cardiovascular risk by 20-30%.  If you have not participated but wish to begin such an exercise regimen, make sure to speak with your health care professional to ensure that it is safe for you.Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.  His most recent book is    “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease“. 

Why Laughter Yoga Can “Heal Your Heart”

Fitness, Health & Wellness

with alexa drubaymadan2laughter yoga2

It has been 10 years since my 1st Laughter Yoga Convention in Miami and over this relatively short period,  new research has provided important insights into why laughter yoga can heal your heart.  Earlier this month I had the distinct pleasure of presenting this research and catching up with colleagues (pictured with Alexa Drubay and Madan Kataria, Founder of the Laughter Yoga Movement) for the Annual Laughter Yoga Convention in Zion, Illinois.  So why is Laughter Yoga so good for you?  Let me count the ways….

  1.  Laughter Yoga improves blood pressure.  Practicing laughter yoga can reduce systolic blood pressure as much as 6 mmHg, corresponding to a 5-10% reduction in stroke risk.  In fact, a large Japanese study found that laughing rarely compared to laughing daily was associated with a 60% increased risk of stroke!
  2. Laughter Yoga reduces aging of our blood vessels.  Risk factors such as stress and high blood pressure lead to premature stiffness and aging of our blood vessels; laughter and especially laughter yoga can slow down and may even to some extent reverse this process.
  3. Laughter Yoga is physical activity.  If laughing without any physical activity can burn calories, just think what a 30-40 minute session of laughter yoga can do…100-200 calories!
  4. Laughter Yoga is a social activity that improves high level social connections. High level social connections is one of my proven prescriptions to reduce stressful brain (amygdala) activity associated with inflammation, heart attack and stroke.

So what are you waiting for?  Go out, explore and enjoy Laughter Yoga in your community…your heart will be most grateful!

Dr. Michael Miller is a cardiologist and Professor of Medicine at the University of Maryland School of Medicine. His latest book is “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease“ with all proceeds donated to the American Heart Association.