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

Move over Wheaties: The New Breakfast of Champions is…

It’s been nearly a century since Wheaties featured Lou Gehrig as the first of many star athletes to grace the cereal box cover and represent “the breakfast of Champions”.   While Wheaties continues to have its fair share of dedicated breakfast fans, a new study suggests that at least from a heart health perspective another food source rises to the top when it comes to the breakfast of champions.  No, I am not referring to cheerios, oatmeal or egg white omelettes.

In fact, this breakfast is not only decadent and mood uplifting but also lowers blood glucose and burns fat.  And the answer is….chocolate!

In the new study conducted in Spain, female volunteers were assigned to consume 3.5 ounces (100 grams), the size of an average bar of milk chocolate.  Beyond their typical food intake, the women were randomly assigned to complete 3 phases; no chocolate phase, chocolate for breakfast phase or chocolate for dinner phase.

The results found that despite the additional ~500 calories from chocolate, there was surprisingly no weight gain when chocolate was added to breakfast.  In fact,  300 fewer calories were consumed on average per day with shrinkage of waist size and reduced cortisol (stress) levels.  Eating chocolate in the morning was also associated with 4.4% decrease in fasting blood glucose levels (by slowing carb digestion) and increased concentration of powerful antioxidants, such as epicatechins.

Bottom line: Women who ate the equivalent of a bar of milk chocolate for breakfast were less hungry throughout the day and consumed less fat and carbs. In addition, the compound theobromine derived from cacao beans, is thought to have contributed to the increased fat breakdown (oxidation) and smaller waist circumference provided that the chocolate was consumed within 1 hour of awakening.  If these benefits were derived with milk chocolate, imagine what a dark chocolate breakfast can do for you!

Listed below are more reasons to start your day with chocolate, the (new) breakfast of champions!

1. Reduces Cholesterol: Combining dark chocolate with almonds and cocoa powder reduces LDL cholesterol; lower LDL is associated with lower risk of heart disease. 
2. Affects Platelet Function: Casual consumption of chocolate was shown to reduce platelet clumping (aggregation).  These antiplatelet effects contribute to the reduction in heart disease associated with consumption of flavanol-enriched foods.
3. Lowers Blood Pressure: The equivalent of 30 calories of dark chocolate (1 Hershey’s dark chocolate kiss) was shown to lower blood pressure. This is due to  blood vessel dilation and improvement in endothelial function (nitric-oxide mediated).
4. Improves Memory: Consuming a drink containing cocoa flavanols improves memory and reduces several measures of age-related cognitive decline.  As a rich source of cocoa flavanols, not only do I add CocoaVia to my morning coffee but I recommend the same for my patients.

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 and Reverse Heart Disease.”: published by Penguin Random House.

 

 

Another Reason to Eat an Apple a Day…

 

The original proverb, “Eat an apple on going to bed and you’ll keep the doctor from earning his bread,” is well recognized in its simplified form (“an apple a day…”) and may now also “keep diabetes away” based on a study released earlier this week.   The new Australian study surveyed dietary habits in more than 7,500 men and women and found that consumption of at least 2 servings of fresh fruits daily was associated with ~35% decrease in developing Type 2 diabetes over the 5-year follow-up period.

Fruits that contributed to this benefit were apples, bananas, oranges and other citrus fruits whereas drinking fruit juice had no effect.   Among the individual fruits tested, only apples were independently associated with lower blood glucose levels and improved insulin sensitivity.

In addition to being a rich source of fiber that slows the absorption of glucose (thereby keeping the pancreas from overworking/overproducing insulin that over time may lead to insulin resistance), apples also contain the flavonoid, quercetin, that suppresses inflammation, a chronic process that promotes insulin resistance.

Because there is a tight intersection between metabolic syndrome, Type 2 diabetes and heart disease, cardiologists are becoming more involved in coordinating care with our diabetes and endocrine specialists.  Ironically, two of the newer classes of medications used to treat diabetes, the SGLT2 inhibitors and GLP1 agonists are being embraced by heart specialists because of proven benefit in reducing cardiovascular risk.

Below are some useful tools to reduce the risk of diabetes and/or lower heart related complications associated with Type 2 diabetes.

1. A new study suggests that eating  an apple a day may also keep diabetes away!
2. If you are overweight and prediabetic (fasting blood glucose 100-125 mg/dL), losing 5-7% of body weight is associated with ~50% reduction in conversion to diabetes; losing 10% of body weight correlated with an 85% decreased risk.
3. The flavonoid quercetin has potent anti-inflammatory properties to combat insulin resistance. Foods with the highest quercetin content include onions, apples, blueberries, broccoli and kale.
4. Large waist size (at least 35 inches in women/40 inches in men) is associated with a greater than 20-fold increased risk of diabetes compared to smaller waist size (less than 31 inches in women/37 inches in men).
5. Treatment with the highly purified EPA compound, Icosapent Ethyl reduced the risk of a heart attack, stroke or death from cardiovascular disease in Type 2 diabetics with elevated triglycerides.
6. Treatment with the diabetic medication known as SGLT2 inhibitors (dapagliflozin, empagliflozin) reduces the combined risk of cardiovascular death or hospitalization from heart failure (with low ejection fraction) in the presence or absence of diabetes.
7. Treatment with the diabetic medication known as GLP1 agonists (liraglutide, semiglutide, dulaglutide) reduces the risk of heart attack, stroke and heart-related deaths in diabetic patients with a history of heart disease, or in the case of dulaglutide, with or without heart disease.
8. The GLP1 agonist, semiglutide used to treat diabetes was just approved by the FDA as a weight management drug to treat overweight/obese adults with diabetes, hypertension or high cholesterol in addition to lifestyle (diet and physical activity) measures.

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….”: published by Penguin Random House. 

Food 4 Thought: Sat Fat & Your Gut

Together with my colleague, Dr. Stanley Hazen, a pioneer in studying the relationship between the gut and heart, our team recently published a paper showing for the first time that a diet high in saturated (Sat) fat produces more unhealthy gut byproducts that a predominantly plant-based diet .  Sat fat sources include animal fats (red & processed meats), fried foods and dairy products.  For more information on this paper click here.

In this study, we randomly assigned men and women to 3 different diets.  One diet was high in Sat Fat modeled after the Atkins Diet,  the 2nd diet was a  Mediterranean Diet resembling the South Beach Diet and the third was the low-fat, predominantly plant based, Ornish Diet.  Each volunteer participated in all 3 dietary phases with each diet lasting 4 weeks.  At the beginning of the study and end of each diet phase, blood samples were collected.  Our results indicated the following:

1. Levels of the gut byproduct known as “TMAO” were highest after the high Sat Fat (Atkins diet) and lowest after the low fat, primary plant-based (Ornish) diet.
2. Two amino acids (valine and leucine) were also highest after the Sat Fat diet compared to the other 2 diet phases.
3. High levels of TMAO and the 2 amino acids listed are linked to increased risk of heart related issues.
4. The bottom line:  Substitute plant-based foods low in Sat Fat for animal products high in Sat (& Trans) Fats- Your heart & gut will thank you!                                Michael Miller, MD is author of “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease” & Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA.