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.
As we get set to leave Baltimore for Philadelphia, I can’t help but reminisce of the great friendships and memories made in “Charm City”. As a baseball enthusiast, moving to Baltimore in the mid-80s brought me an even greater appreciation of GH (Babe) Ruth, the hometown hero and legendary “Sultan of Swat”. Over the past several decades, my hobby of collecting baseball memorabilia rose to a new depth as I pursued Ruth-related collectibles. Of the 7 baseball cards illustrated, 5 are of the Bambino himself (from the 1933 Goudey and 1948 Leaf set), 1 is of his teammate, Lou Gehrig (1934 Goudey) and on the upper right, is the 1909 T-206 Ty Cobb (green background) acquired from the estate of Babe Ruth’s cousin shortly after my move to Baltimore from Cincinnati.
It is no surprise that we commonly refer to Baltimore as “Small”-timore because there are so many interconnections…in the case of Babe Ruth, I pass by his birth home nearly every day as the University of Maryland Hospital is just a block away. Ironically and many decades earlier, my wife’s family (generations of native Baltimoreans) at one time owned the pub where Babe Ruth’s father was employed (currently the centerfield area of Camden Yards). Even our 13-year-old cockapoo is aptly named “George Herman”!
Listed below are reasons to engage in a hobby that is appealing to you.
As we age, the loss of high frequency sounds becomes a common sign of hearing impairment due to degenerative changes in the inner ear. High frequency hearing loss is common in the U.S. (~1 in 5 adult men and women are affected) and the classic sign is a decreased ability to hear high pitched sounds (voices of children/women) as well as to decipher conversations in a crowded room. Loss of low frequency sounds (voices of men, thunder, bass) is less common but is also an important cause of hearing loss.
Despite the ravages bestowed by COVID-19, more than 500,000 men and women worldwide have attained centenarian status (living to 100 years and beyond), including nearly 100,000 residing in the U.S. Among this special group was my beloved father-in-law, Paul Miller, who taught math for 80 years and lived to the ripe young age of 104!
Many of us both inside/outside the medical profession find these individuals to be awe inspiring especially when they are still in relatively good physical and mental health upon reaching this major milestone. While we appreciate that exceptional longevity may be more heavily concentrated in a “Blue Zone“, the overwhelming majority of centenarians do not live in these regions. In fact, there are nearly 2,000 centenarians living in the great (though non-Blue Zone U.S.) state of Maryland!
Now a new study published in the prestigious journal, Nature, is assisting scientific efforts toward unlocking secrets for healthy aging and longevity. The study conducted in Japan, found that centenarians had high levels of protective gut byproducts. Also known as isoalloLCA, these secondary bile acids, contribute to gut health by inhibiting gut bacteria that promote inflammation and disease (such as C. difficile). While a cause-effect relationship between protective gut byproducts and longevity has yet to be established, this study is an important step in furthering our understanding of the relationship between gut and overall health.
Listed below are other secrets to enhance the likelihood of healthy longevity.
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!
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!
For my patients who enjoy their java, I recommend 1-2 cups daily, with the 2nd cup consumed in the early afternoon, at least 8-10 hours prior to bedtime to reduce insomnia. In addition, because of cancer concerns related to the toxin acrylamide that is released when coffee beans are roasted, I recommend staying away from instant and light roasted coffee brands (due to higher amounts of acrylamide) and stick with medium and dark roasted varieties.
Below are additional health benefits from your morning (and afternoon) mug.
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.
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.
A new study suggests that eating an apple a day may also keep diabetes away!
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.
Listed below are notable highlights from this review:
Periodontal disease (PD) is common in the U.S., (affecting 46% of adults) and is associated with a 3.5-fold increased risk of cardiovascular disease. Risk factors for PD include smoking, diabetes, obesity, emotional stress and poor oral hygiene.
Severe periodontitis is associated with impaired vascular health and a higher risk of heart attacks.
A specific bacteria isolated from dental plaque (Streptococcus sanguis) is associated with an increased risk of blood clots.
PD is associated with insulin resistance and worsening glycemic control whereas intensive periodontal treatment improves glucose control in diabetics.
Cigarette smoking is associated with a 20-fold increased risk of gingivitis and PD.
Fifteen or more cigarettes smoked daily raises the risk of tooth loss by 3-fold.
Poor oral hygiene may be an independent risk factor for hypertension.
If you have PD and are hypertensive, you are less likely to respond to blood pressure medications or achieve BP control!
The Bottom Line: Good oral hygiene is pivotal for maintaining a healthy heart!
Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland. Make sure to check out his daily heart health tips on twitter (https://twitter.com/mmillermd1) or Facebook: (healyourheartbook).
“Back in the day…” is the way I like to regale stories of my medical school experience with current students. In fact, just the other day I recalled that when I was a medical student, high blood pressure was defined by taking the age of the person and simply adding 100. In other words, a 60-year-old could have a systolic blood pressure up to 160 mmHg before many physicians would be concerned that it required treatment!
Fast forward a handful of decades later, and a systolic blood pressure of 160 mmHg is now considered very serious (Stage 2) and one that commonly requires multiple blood pressure medications in addition to a low sodium diet and healthier lifestyle. Yet many people with high blood pressure don’t appreciate the importance of following a low sodium diet. Back in the day, we permitted up to 4000 mg of sodium or ~1.5 teaspoons of salt daily (we called it a “no added salt” diet).
Today, if you are otherwise healthy, maintain a blood pressure of less than 120/80 and are younger than 50, it is reasonable to adjust your sodium intake ~2300 mg per day (1 teaspoon of salt). However, if you are at least 50 years old or have a history of hypertension, diabetes or kidney disease, the recommendation is to consume less than 1500 mg of sodium (~2/3 teaspoon of salt) daily.
Listed below summarize 4 key findings related to blood pressure:
A normal blood pressure is less than 120 (systolic)/80 (diastolic) mmHg.
High blood pressure causes blood vessels to constrict/stiffen and leads to “premature vascular aging”.
For every 20 mmHg increase in systolic (or 10 mmHg increase in diastolic) blood pressure, the risk of a heart attack/stroke doubles!
In addition to heart attack and stroke, other feared complications of long-standing hypertension include kidney failure and heart failure.
Over the coming week, check out the “HeartHealth Tip of the Day” on Twitter: @mmillermd1 or Facebook: “healyourheartbook” for additional information on this topic.
Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland. For many more tips on how to optimize your heart health, check out his book, “Heal Your Heart…”: published by Penguin Random House.
During my training, I had the good fortune to be mentored by the late Dr. Peter Kwiterovich Jr., a true pioneer in the cholesterol field. In fact, “Dr. Pete” as he was affectionately referred to by his patients, (many of whom were children/teenagers since he was a pediatrician by training), started the Johns Hopkins Lipid Clinic in the early 1970s, years before “cholesterol” became a household word. Needless to say, his 1989 book, “Beyond Cholesterol: The Johns Hopkins Complete Guide for Avoiding Heart Disease” has stood the test of time and remains a classic for anyone interested in learning why “it’s more than just cholesterol”. Still, cholesterol remains an important predictor of heart disease (conferring up to 50% of heart attack risk) and lowering your levels of low-density lipoprotein (LDL) or “bad cholesterol” will reduce your overall risk of a cardiovascular event. In this post, 5 foods are discussed that lower LDL cholesterol levels naturally. If you incorporate each of these 5 foods daily, you can lower LDL upwards of 15-20%! Whether or not lowering LDL through diet/lifestyle alone is sufficient, depends upon your overall risk of a heart attack/stroke and should be discussed with your health care professional.
Beta-glucan: a type of viscous fiber, found in barley, mushrooms (e.g., shiitake, reishi) and seaweed, can have significant LDL lowering effects; each gram of beta-glucan consumed daily reduces LDL ~2 mg/dL. Try a hearty bowl of vegetable barley soup with shiitake mushrooms and lower your cholesterol naturally! Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland. For many more tips on how to optimize your heart health, check out his book, “Heal Your Heart…”: published by Penguin Random House.