Inflammation: The HOTTEST Topic in Heart Disease



A landmark study led by my friend and colleague, Dr. Paul Ridker, shows for the first time that reducing inflammation not only lowers risk of a future heart attack, stroke or death from heart disease but may also affect the risk of lung cancer.  Effectively fighting inflammation with medication is not new, but medications, like statins not only reduced inflammation but also cholesterol so that the basis for the benefits were unclear. The importance of this groundbreaking study is that the medication purely reduced inflammation without affecting cholesterol (or other factors implicated in heart disease).

In other words, lowering inflammation represents an important new way to improve heart health.  That said, listed below are 6 simple things you can do to keep inflammation at bay, everyday.

  1.  Stretch when you wake up.  I remind my patients that physical stress will cause internal stress that can promote inflammation. Therefore, I recommend spending a few minutes each morning doing simple stretch exercises to remain limber and more relaxed throughout the day.
  2. Enjoy a morning cup of java (or tea).  Believe it or not,  coffee contains powerful chemicals like chlorogenic acid that not only fights inflammation but may also help to combat depression. So enjoy your morning cup of java or tea (that has similar properties).
  3. Keep air and noise pollution levels down.   You may not be able to control air and noise pollution levels outside your home or office but it is important to reduce them as much as you can because pollution can be a major source of inflammation. So, keep the windows up when driving down those noisy and polluted city streets and instead, try listening to….
  4. Listening to your favorite music will reduce inflammation.  In fact, listening to your favorite music not only combats daily stressors but is among the most powerful ways to fight inflammation.  So turn it up… but not too loud, because hearing loss is also linked to heart disease!
  5. Enjoy your greens and berries too! Veggies and fruits and among the best food sources to beat inflammation.  In addition to your favorite green salad, I recommend 1 handful of blueberries, 6 strawberries and of course, the proverbial apple each day.  If available, try bergamot, a fruit rich in anti-inflammatory chemicals.
  6. Check out your favorite comedy.  That’s right, a good, hearty laugh will fight those inner inflammatory demons.  Some of my faves include  “Disjointed” , “Young and Hungry” and “Rules of Engagement“.

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“.   All proceeds are donated to the American Heart Association.


Secret Words of Wisdom from a 100-Year Old Teacher

Hall of fame 016I once asked Paul Miller, a 2011 inductee in the National Teachers Hall of Fame and featured this week on NPR, what he viewed as his secret(s) to a long, healthy and happy life.  Here are some of the words of wisdom he shared that if we live by can make this world a better place… Paul certainly has!

  1. Treat everyone with respect:  Paul not only taught but tutored students from all walks of life; for more than 75 years spanning the educational cycle from kindergarten through college, he taught math at public and religious (Jewish and Christian) schools, Universities (Johns Hopkins, University of Maryland, Towson University, Coppin State). In all, he taught at more than 25 different schools, displaying respect for his students.
  2. Love what you do: Paul loved to teach and even after he suffered a heart attack, the first thing he asked his doctor was when would he be able to go back to teaching.
  3. Enjoy being around younger people: Paul especially loved teaching young students and found elementary through high school to be the most challenging yet most rewarding. Young people have energy and an optimism that all too often recedes with age.
  4. Don’t hold a grudge: If Paul had a hard day at school, he would not let it get to him and move on the next day, often forgetting that anything happened the prior day.
  5. Keep your mind active: Paul always did crossword puzzles and solving math problems. Nearing 101, he is still adept at answering square root problems!
  6. Don’t take yourself too seriously: Paul continues to laugh easily and often, even when it is at his own expense.
  7. Maintain a spiritual connection: Believing in a higher power can be comforting and help to reduce stress during life’s most difficult times.


Bergamot: The Sour Fruit with Sweet Benefits


Bergamot citrus

Bergamot citrus is a sour tasting fruit combining orange, lemon and a twist of lime flavor. Although used in aromatherapy, cosmetics and food for many years, Bergamot has recently gained acclaim in medical circles due to studies demonstrating benefits on heart and overall health. Check out some of the benefits based on the published studies listed below and why you should consider Bergamot citrus as part of an overall prescription for good health.

    1. Bergamot lowers cholesterol by reducing  LDL (bad cholesterol) by 15-20%, triglycerides (blood fats) by 20-30% and buildup of cholesterol plaques.
    2. Bergamot has powerful antioxidant activities and may be particularly helpful in diabetes and with other metabolic risk factors.
    3. Bergamot reduces blood pressure and heart rate variability, an excellent measure of how our heart responds to stress.
    4. Bergamot possesses powerful anti-inflammatory properties, and inflammation is one of the hottest areas in heart disease!
    5. Bergamot aromatherapy improves mood, If for no other reason, an uplifting mood will lighten your day.(Photo attribution to Leslie Seaton)


Dr. Michael Miller is a cardiologist and Professor of Medicine at the University of Maryland School of Medicine. His latest book, “Heal Your Heart…” is available on Amazon with 100% of proceeds donated to the American Heart Association.

Spice up your Summer with Sumac


sumac spice

sumac salad

As we learned during our recent trip, Sumac is a Middle Eastern herbal gem. This tart and sour spice adds a flavorful kick when used as a sauce or sprinkled on chicken, fish and salad (see our peach, beet, almond and greens above). But it is Sumac’s medicinal properties that takes this colorful spice to the next level, making it well worth its weight in “burgundy” gold.

Here are 7 reasons why you should pay a visit to your local Middle Eastern market.

1. Sumac reduces inflammation,  an important contributor to heart disease and other chronic conditions.  (Stay tuned for the results of a landmark study examining the effect of reducing inflammation on heart disease).

2. Sumac improves blood glucose control in diabetics by reducing insulin resistance.

3. Sumac has powerful antioxidant effects.  The powerful antioxidant PON1, is believed to contribute to the heart-protective role of HDL, “the good cholesterol”.  Check out this recent study.

4. Sumac may raise the level of HDL cholesterol.

5. Sumac may reduce growth of certain tumors. 

6. Sumac may slow the aging process.

7. Sumac expands blood vessels that in turn may lower blood pressure.

Bottom Line: Spice up your summer with Sumac…it will not only brighten your day but it’s also good for your heart!

Dr. Miller is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine. His most recent book, “Heal Your Heart…” is available on Amazon with all proceeds donated to the American Heart Association.


Tel Aviv: A Heart Healthy Culinary Destination

carrots israeliisraeli saladsdennis fish

Israel enjoys one of the highest life expectancy rates worldwide, 82.5 years on average (more than 3 years higher than America’s 79.2).  Having recently visited the country, it is easy to see why.  First, Israelis’ are fit- a mandatory 3-year Army enlistment helps in developing lifelong habits for maintaining excellent physical conditioning. In Tel Aviv, there are 44 miles of designated bicycle routes and numerous exercise machines that line the beach making it convenient to grab a workout any time of day or night. Equally impressive are the delicious assortment of fruits and vegetables, amazing spices and healthy culinary delicacies. Among my favorites were the humongous carrots. These antioxidant powerhouses also produce incredibly sweet carrot juice; make sure to check it out when you visit the country. Another culinary gem adding to the Israeli dining experience was the customary assortment of small salads that included hummus, beets, eggplant, tahini, herring, cucumbers, tomatoes and of course, carrots. Of the many outstanding dining experiences, my favorite was Shtsupak (; make sure to try the Denis (sea bream) fish that is native to Israel. It is an excellent source of Vitamins B6, B12 and Selenium that is guaranteed to boost your mood and Heal Your Heart.

Wine & Chocolate: What is the SWEET Spot for heart health?

mm at tiih 2017

Recently, Jinji Fraser of Pure Chocolate by Jinji, Michael Zollo of Crow Vineyard and I promoted the health benefits of wine and chocolate at The Institute for Integrative Health.

Wine and chocolate are chock full of powerful antioxidants that can boost mood, increase blow flow, reduce stress and have other health benefits.

-In fact, NEW studies have shown that:

  1. 1 glass of red wine each day may improve blood glucose levels in adults with Type 2 diabetes.
  2. 1 serving of dark chocolate each day is associated with a 16% reduced risk of atrial  fibrillation

So what is the “sweet spot” for good heart health ?

-Alcohol:  Men (1-2 servings per day) & Women (1 serving per day): 5 ounces of wine OR 12 ounces of beer OR 1 shot of spirit.

-Dark Chocolate: 1 ounce (approximates the width of your 2 thumbs).

Dr. Miller is Professor of Cardiovascular Medicine, University of Maryland School of Medicine in Baltimore, Maryland and Member of the American Heart Association Nutrition and Lifestyle Committee.  His latest book is “Heal Your Heart: The Positive Emotions Prescription” with 100% of proceeds donated to the American Heart Association.




For a Healthy Heart, Chop the Animal Fat!

t-bone steak

It was a great privilege to serve with my esteemed colleagues, led by Dr. Frank Sacks, on a Presidential Advisory statement  entitled “Dietary Fats and Cardiovascular Disease” commissioned by the American Heart Association and published in.Circulation

Some of the main points are:

1. Replacing 10% of calories from Saturated fats (such as beef tallow, butter and lard) with Polyunsaturated fats (such as corn, safflower & soybean oils) REDUCES RISK OF HEART DISEASE BY 50%

2.  Replacing 10% of calories from Saturated fats with Monounsaturated fats (olive oil) REDUCES RISK OF HEART DISEASE BY 30%

3. Replacing 10% of calories from Saturated fats with Complex Carbs (whole grains) REDUCES RISK OF HEART DISEASE BY 18%

4. Replacing 10% of calories from Saturated fats with Simple Carbs (refined starches/added sugars) DOES NOT REDUCE RISK OF HEART DISEASE

As a cardiologist, I recommend that you chop out or restrict animal fat.  However, for my meat loving patients who will not give up their favorite steak, limit intake to no more than 3-4 ounces per serving and aim for a lean cut of beef.  At a restaurant, I recommend asking your waiter to have the chef divide the steak up front (for sharing or placing into a take home box) and filling up your plate with fresh salad instead.

Dr. Miller is Professor of Cardiovascular Medicine, University of Maryland School of Medicine in Baltimore, Maryland and Member of the American Heart Association Nutrition and Lifestyle Committee.  His latest book is “Heal Your Heart: The Positive Emotions Prescription…” (Rodale Press).



Taking this Study with a Grain of Salt

File:Rock salt, Klodawa Salt Mine, central Poland.jpg

Americans consume sodium in excess by approximately 1,000 mg per day (approximately 3,400 mg versus the recommended amount of 2,300 mg or 1 teaspoon of salt) in men and women younger than age 50 years and more than twice as much sodium than recommended (1,500 mg) for older men and women. Yet, despite promotional efforts by government agencies and the media to get this information out into the public domain, the progress made toward reducing the purchase of sodium-enriched products has not been well established. The new study examines the national trend in sodium reduction in U.S. households over a 15-year period by focusing on package foods and beverages, two of the richest sources of sodium consumed by Americans.

A recent study found average reductions in sodium of 12% from packaged goods purchased between 2000 and 2014. On the surface, this may seem like a significant improvement over the study period. However, the analysis did not include foods that did not contain a barcode, such as the popular, “grab-a-ticket” deli counters where lunchmeats are commonly seething with sodium. For example, one slice of deli ham often contains 300-400 mg of sodium. Because approximately one-half to one-third of daily sodium intake may be obtained from deli meats and popular store-prepared foods (also not assessed for sodium content), not having this information puts somewhat of a damper on an otherwise informative and interesting study.

This blog was originally posted on Healio (June 7, 2017).

Dr. Miller is Professor of Cardiovascular Medicine, University of Maryland School of Medicine and author of “Heal Your Heart” with 100% of proceeds donated to the American Heart Association.



Matcha is a finely ground, bright green powder made from tea leaves. However, in contrast to traditional green teas, matcha undergoes specialized processing that produces a 100-fold higher concentration of one of nature’s most powerful antioxidants, EGCG. Matcha also contains the mood-boosting compound, theanine; between this one-two power punch, I am convinced that matcha is the real deal to be routinely recommended for my patients as part of an overall prescription for vibrant health. Below are some of the impressive research findings to date.

  1. IMPROVES MOOD. Matcha provides a dazzling dose of the chemical L-theanine that, coupled with a modest amount of caffeine, facilitates focus, concentration and memory. The calming effect of theanine also helps to take the edge off, ensuring an immediate upswing in mood. It is rare to find a natural product that possesses such diverse mind-enriching properties.
  2. SLOWS SIGNS OF AGINGPromising animal research has found that the potent       antioxidants contained in matcha not only slow the aging process, but may protect the brain from the progressive deterioration accompanying dementia. Human studies are evaluating EGCG as potential therapy for early Alzheimer’s Disease, so stay tuned!
  3. BOOSTS ENERGY + ENDURANCEStudies involving moderate-intensity exercise have found that the compounds contained in matcha boost energy metabolism, leading to improved exercise endurance and stamina while reducing belly fat.
  4. HELPS US DETOX.  A study just published in March found that EGCG not only lowered blood sugar but also delayed the buildup of toxins that cause the eye, kidney and heart damage that all too commonly complicate diabetes.
  5. IMPROVES SLEEP QUALITYNot only does L-theanine produce a calming effect during wakefulness, but recent studies suggest that this compound can also influence the sleep cycle and promote more restful sleep cycles.
  6. HEART HEALTH BFF. The primary antioxidant compound in matcha, EGCG dilates blood vessels and lowers blood pressure, cholesterol, inflammation and development of blood clots. Taken together, matcha possesses inherent properties that protect against heart disease and keep our blood vessels young and healthy.
  7. FIGHTS THE BIG C? Matcha’s powerful antioxidant and anti-inflammatory properties inhibit the activity of tumor cells in lung, breast and prostate with a host of other cancers under active investigation. Clearly, we have only begun to scratch the surface in realizing matcha’s potential for preventing – and preventing the spreading of – invading cancers.
  8. REDUCES INFLAMMATIONA recent review found EGCG to reduce inflammation and impairment of brain function associated with MS. Two studies evaluating EGCG treatment for MS were recently completed and results should be available soon.

This blog was originally posted on The Chalkboard (May 22, 2017).

Dr. Miller is a Professor of Cardiovascular Medicine, University of Maryland School            of Medicine and Author of Heal Your Heart: The Positive Emotions Prescription          to Reduce and Prevent Heart Disease (Rodale Press).

Eggs: Do They Deserve A Beating?

The Doctors 2

Recently, The DOCTORS Show invited my colleague Andrew Freeman, MD and me to participate in “The Great Food Debate”. In this segment, our debate focuses on eggs. I don’t know about you, but I love eggs. Growing up, my grandmother would cook up my favorite breakfast: eggs over easy, with lots (and lots) of pepper…absolutely delicious!

However, over the years, eggs have been beaten up (in more ways than one); some of my colleagues, including Dr. Freeman, believe that eggs are unhealthy because they contain too much cholesterol and choline. Some studies even report that too many eggs cause diabetes!

As it turns out, the amount of cholesterol in egg yolks (150-160 mg) is about 50% lower than it was back in the 70s (due in part to changes in hen’s feed and accuracy of cholesterol measurements). Choline is an important nutrient that is not only necessary for brain function, but also improves mood and suppresses anxiety. In addition, choline reduces levels of homocysteine, an amino acid that can be toxic to our heart and blood vessels.

With regard to the concern that eggs “cause” diabetes, let me paraphrase a recent paper the nicely summarizes the evidence from multiple studies. That is, consuming 6-12 eggs weekly along with following heart-healthy eating patterns has NO effect on cholesterol, fasting glucose or C-reactive protein (a marker of inflammation).

What egg critics fail to point out are that egg whites contain a healthy content of protein and minerals (magnesium, selenium) whereas the yolk is enriched in vitamins (A, B12, D, E, Folate, K), minerals (calcium, iron, selenium, zinc) and carotenoid pigments (lutein, zeaxanthin) that reduce risk of eye diseases such as cataracts.

Overall, I place no restriction on egg whites, and the only time I recommend egg yolk restriction is for my patients with very high cholesterol levels (LDL levels above 160 mg/dL).  Otherwise, go enjoy your favorite omelet (mine is spinach, onions, mushroom and tomato)!

Dr. Miller is a Professor of Cardiovascular Medicine, University of Maryland School of Medicine and Author of Heal Your Heart: The Positive Emotions Prescription to Reduce and Prevent Heart Disease “ (Rodale Press).