Healthy Eating for a Healthy Heart Heart Health Month

February is American Heart Health Month so nothing is more important than to discuss nutrition. What to eat and what not to eat for a healthy heart. This is often a confusing subject for many people, complicated by a plethora of contradicting diet books/plans, all claiming to be heart healthy. I personally don’t like the word “diet” because it implies a temporary change in how you eat only to resume prior habits. What I think is important is to have a nutritional way of life that becomes your new habit.

As a cardiologist, I have used many tools including medications and interventional cardiac procedures to “treat” my patients. However, without the patients taking the necessary lifestyle changes, including proper nutrition, exercise, smoking cessation, and stress management, all I have done is put a band-aid on their disease. It’s time to focus more on prevention and to empower patients to heal themselves because heart disease is largely preventable.

I recently read “Eat to Live” written by Dr. Joel Fuhrman and I strongly recommend this book for anyone wanting to be healthy. Dr. Fuhrman is a board-certified family physician and nutritional researcher. While it technically is a weight loss book (obesity being a major risk factor for heart disease), I think it is valuable for everyone. The basic concept is that

Health = Nutrients/Calories

Your health is predicted by the amount and quality of nutrient intake (vitamins, minerals, fiber, and phytochemicals) in your caloric intake (carbohydrates, fats, and protein). The higher the ratio, the healthier you are. This simple approach to eating not only results in significant, sustainable weight loss but also helps to PREVENT heart disease and cancer.

Our Modern American Diet is MAD. Over 90 percent of calories consumed by Americans comes from refined foods or animal products, both of which are essentially devoid of nutrients.

“Refined” foods are foods that have been processed or altered, such as grains, sugar, and oils, so that they are no longer in their natural state. While words such as refined or enriched may sound good, it is quite the opposite.

  • Limit (if overweight, Avoid) Refined Carbohydrates such as bread, pasta, cold cereals, muffins, bagels – you get the point
  • Limit sugar
  • Limit processed foods (because they are refined, contain sugar and are empty calories)
  • Limit animal foods

Animal foods increase the risk, not only of heart disease but also many cancers. All animal products are low (or completely lacking) in the nutrients that protect us against heart disease and cancer – antioxidants, vitamins, fiber, and phytochemicals. The risk is linked to all animal foods, including lean meats and poultry and appears to be related to the animal protein as much as the animal fat.

So, what foods are nutrient dense and therefore heart healthy

  • Green leafy vegetables – kale, chard, collard greens, spinach, arugula
  • Other green vegetables – broccoli, asparagus, string beans, peas, Brussel sprouts
  • Non-green vegetables – beets, eggplant, mushrooms, onions, radishes, bean sprouts, bell peppers, cauliflower, carrots
  • Fresh Fruit– all berries, apples, bananas, peaches, pineapple, grapes, kiwi
  • Beans – lentils, kidney, great northern, black, pinto, chickpeas, edamame
  • Raw nuts and seeds – sunflower, pumpkin, sesame, flaxseeds, almonds, cashews, walnuts, pistachios, pecans, hazelnuts
  • Colorful starchy vegetables – sweet potatoes, squash, turnips
  • Whole grains – oats, barley, brown rice, buckwheat, quinoa, bulgur, millet, whole grain bread


As you can see, there’s a lot of good stuff here. Nutritional density is highest at the top and decreases going down the list. So when you’re thinking about what to eat, start at the top, make the greens the largest portion of your daily food consumption and then add the others.

Changing how we eat is not easy. Trust me, I understand (yesterday I had pasta and wine). Eating is emotional and social. But it is also the only way to real health. It is a choice we make for ourselves and our families. I suggest aiming to consume 60 percent of your calories from nutrient dense plant foods. This is 10 times what most Americans consume and will decrease your risk of heart disease (and cancer) significantly. Let’s get started and stay healthy.

Let food be thy medicine” – Hippocrates


Millie Lee, MD


February is Heart Health Month What You Should Know for a Healthy Heart

February is Heart Health Month – A time to raise awareness of the seriousness of heart disease and how to prevent it.

What you should know About Heart Disease

Cardiovascular Disease (Heart Attacks, Heart Failure, & Strokes) sadly remains the leading cause of death in the United States for both men and women.  Here are some startling statistics.

  • One in four deaths in this country is caused by heart disease.
  • In 2008, over 616,000 people died of heart disease.
  • Coronary heart disease (i.e. blockages in the heart arteries) is the most common type of heart disease
  • Every year about 785,000 Americans have a first heart attack. Another 470,000 who have already had one or more coronary attacks have another attack
  • In 2008, 405,309 people died from coronary heart disease.
  • In 2010, coronary heart disease alone was projected to cost the United States $108.9 billion. This total includes the cost of health care services, medications, and lost productivity.

Source: Centers for Disease Control and Prevention

These are shocking statistics in spite of the tremendous advances we have made in the treatment of heart disease.

You may ask why? You should ask why because with these frightening statistics it is very possible to affect you or a loved one.

What you should know for a healthy heart

In my professional opinion as a cardiologist, it is because people are not aware they are the empowered ones to prevent and nearly eliminate this disease (not doctors or scientists). Likewise, many are not aware of the warning signs and symptoms and thus do not act quickly enough to avoid death or limit the damage from a heart attack.

Good News – Heart Disease is predominantly preventable! Yes, PREVENTABLE!  So, don’t wait for it to happen… because it will if you don’t do something now. It’s never too late to reduce your risk of heart disease.

This month, I will focus on heart disease -facts you should know and more importantly, how to prevent it!

Common risk factors for heart disease

  • Hypertension or High Blood Pressure
  • Diabetes Mellitus or High Blood Glucose
  • Hypercholesterolemia or High Cholesterol
  • Smoking Cigarettes
  • Stress
  • Age
  • Family History of Premature Heart Disease

Looking at this list, you can see that almost all are preventable -Hypertension, Diabetes, High Cholesterol, smoking, and stress.

 Sorry.. can’t do too much about your age or family (although even our genes are modifiable!).

All of these risk factors are preventable with proper nutrition, exercise and stress management. It is not difficult, but it does require a commitment to your health every day. Next blog, I’ll talk about heart-healthy foods. Here’s a sneak peek! It’s this easy.


First tip for Heart Month: WALK. Log those steps. Every step you take is a part of your journey to heart health. Walking briskly can reduce your risk of high blood pressure, diabetes, and high cholesterol.

Rx: 150 minutes a week of moderate-intensity physical activity (brisk walking) or 75 minutes a week of vigorous-intensity physical activity (such as jogging or running) or a combination of both.

Click here to learn more from the American Heart Association

Dr Lee signing off…..

till next time!



Periodic Cleansing &Detoxification is Important for Health & Wellbeing Time to Detox

“When the body is cleansed, the mind purified and the senses controlled, the joyful awareness needed to realize the inner self also comes.” – Yoga Sutra


Why do a Cleanse or Detox? Why stop eating the things you “love” or “need” like coffee, dairy, carbs, and alcohol?

Our bodies have an amazing capacity to neutralize & eliminate many of the toxins that we are exposed to in everyday life. These toxins are in the form of food, water, alcohol, tobacco, drugs, including prescribed medications and external toxins such as pollution. As you can imagine, our natural detox systems get seriously overburdened. Furthermore, these natural detox systems rely on many dietary vitamins and minerals to aid in the process. Unfortunately, most people are not consuming these vital nutrients.

Now while maintaining a healthy diet and lifestyle every day is the best way to avoid overburdening our detox organs (liver, kidneys, lungs, skin, colon, lymphatic system), it is not always the case. So, I believe, that occasional cleanses can be beneficial to restore the body’s natural detoxification systems.

This is done by decreasing the number of toxins we put into our bodies while at the same time supporting our body’s detoxification and elimination systems (liver, kidneys, lungs, skin) with the nutrients it needs to function properly.

I have tried a number of different cleanses and they all have their pros and cons. The different types of cleanse include the Master Cleanse, Juice Cleanse, Raw Food Cleanse, Colon Cleanse, and various combinations. They can range from one day (not long enough) to several weeks.

This time I am doing a 3-day Juice cleanse with Pressed Juicery. You drink 6 juices each day, which are a blend of raw, organic vegetables and fruits. You do not anything solid to rest the digestive system and eliminate all toxins including caffeine, dairy, and alcohol. I like this cleanse for several reasons: the juices taste great, it’s effortless – no time spent on preparation and its portable.

Be forewarned, you will likely feel worse before you feel better – that is withdrawal from the toxins. I definitely felt the detox physically; the body initially feeling fatigue and muscle soreness as the toxins are released from the cells of the body. But then you feel energized and healthy. You will sleep better. The skin glows from inside out. And, for many people, you lose some weight.

I also take this time to detox at all levels, not just the physical, but the mental and spiritual, letting go of toxic thoughts and emotions. Your mind becomes clear as you let go of toxic thoughts and your heart becomes light as you let go of toxic relationships and anything that no longer serves you. I guess that’s why fasting and cleansing rituals have been an important part of many cultures and religions for thousands of years.

One of the principles of Yoga is Sauca, Sanskrit for purity, cleanliness of mind, body, and spirit. A purified body and mindful eating is just one component. Asana (postures) and Pranayama (Breathwork) are also powerful means to cleanse our physical bodies. “The practice of asanas tones the entire body and removes the toxins and impurities caused by over-indulgence. Pranayama cleanses and aerates the lungs, oxygenates the blood and purifies the nerves” (BKS Iyengar, “Light on Yoga”). Hot Yoga (my favorite) potentiates the detoxification process.

At its very core, Sauca is about purity of the heart. So, live with a pure heart and good intentions and Feel your divine goodness.


Dr Millie Lee

Heart Disease – Signs and Symptoms

We continue this month, Heart Month, to learn more about the heart and heart disease.

So how do you know if you or a loved one have heart disease? First of all, what is heart disease? Before we discuss what can go wrong, Let’s begin with a short lesson on the anatomy and function of a normal heart.

Human Heart Anatomy

The heart is a small, beautiful and powerful organ. It is about the size of a large fist and weighs between 10-20 ounces in mean and 8-10 ounces in women.

Heart Function and what can go wrong 

We cardiologists often liken the heart to a house with its structure, plumbing and electricity. The heart is a hard working muscular pump responsible for delivering oxygenated blood to all the bodies tissues and organs, including itself (via the coronary arteries). If the pump (structure) fails to work efficiently, heart failure can result. If the arteries get clogged or blocked (plumbing), Coronary Artery Disease is the result. Irregular heartbeat or arrhythmias is the result of an electrical problem.

Coronary Artery Disease (CAD)

CAD is what most people think of when they hear the term heart disease and it IS the most common form of heart disease and the leading cause of death in our country. Basically, it is the build-up of plaque in the heart (coronary) arteries which lead to symptoms of ANGINA or HEART ATTACK (myocardial infarction).

Angina occurs when the heart muscle doesn’t get enough oxygen rich blood. It generally occurs when the demand on the heart is increased such as with exercise or exertion and resolves with rest (decreased demand). A heart attack is similar pain that persists. It can often be preceded by angina, but not always.


  • Chest pain with or without exertion; dull, pressure, sharp or burning like indigestion
  • Pain in Arms, Neck, Jaw, Back or Abdomen
  • Nausea and vomiting
  • Shortness of Breath
  • Extreme Fatigue
  • Sudden, unexplained sweatiness

Heart Failure

This is a condition in which the heart does not pump normally, either from a weakened pump or a restricted heart muscle. The condition of a weakened heart muscle is referred to as a Cardiomyopathy. When the heart is not able to pump efficiently, blood can back up into the lungs and peripheral veins. As the pressure in the blood vessels of the lungs increase, fluid is pushed into the air spaces, leading to congestion in the lungs, or pulmonary edema. Similarly, fluid can be pushed out of the peripheral veins, leading to swelling or EDEMA of the legs, arms, or abdomen.


  • Shortness of Breath with or without activity
  • Shortness of Breath when laying down
  • Fatigue
  • Swelling, in legs, arms, and abdomen


An arrhythmia is a problem with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm, such as Atrial Fibrillation.


  • Palpitations
  • Dizziness, Lightheadedness, Loss of Consciousness
  • Chest pain
  • Shortness of Breath

If you or a loved one have any of the symptoms I’ve discussed here, please see a doctor as soon as possible. I recommend seeing a general doctor first and see if referral to a specialist or further testing is required.

By Dr. Millie Lee

Heart Health Awareness Month

February is Heart Awareness Month – A time when many of us connect with our hearts. This connection is primarily because of the holiday, Valentine’s Day. But along with Valentine’s Day, February also marks American Heart Month, a great time to commit to a healthy lifestyle and make small changes that can lead to a lifetime of heart health. Heart disease is still the leading cause of death of men and women, despite the tremendous advances we have made in the treatment of heart disease. So, maybe the solution for heart health is prevention. Make heart health the perfect gift you give to yourself and your loved ones this Valentine’s Day.

This month, follow along as we discuss various aspects of heart health, including risk factors, prevention, screening, heart healthy diet and stress management.

Let’s start by asking ourselves: Am I at risk for heart disease?

Common risk factors for heart disease

  • Hypertension or High Blood Pressure
  • Diabetes Mellitus or High Blood Glucose
  • Hypercholesterolemia or High Cholesterol
  • Smoking Cigarettes
  • Stress
  • Age
  • Family History of Premature Heart Disease

The good news is that most of these are preventable, modifiable and treatable with attention to the right foods and regular exercise. Sorry.. can’t do anything about your age or family.

So, let’s get Heart Smart this month and beat heart disease. February 3th is National Wear Red Day to raise national awareness of heart disease. Why not wear red everyday this month to maintain awareness to our heart health.

First tip: WALK. Log those steps. Every step you take is a part of your journey to heart health. Walking briskly can reduce your risk of high blood pressure, diabetes, and high cholesterol. Rx: 150 minutes a week of moderate intensity physical activity (brisk walking) or 75 minutes a week of vigorous intensity physical activity (such as jogging or running) or a combination of both.  Keep me posted on your progress and send pictures of your activities wearing red!


Dr Lee signing off…..


Winter Can Be Hazardous to Your Heart

As winter kicks off and snowstorms strike across the country,

the risk of heart attack rises.

Fact: More people die of heart disease in the winter, especially the months of December and January. Why?

We’ve all heard the stories about someone who suffered a heart attack while shoveling snow.  Is it the cold weather? Is it the physical activity? Is it the dark days of winter? Is it stress? Turns out, all of these factors play a role.


Cold weather causes the arteries to constrict, which then raises blood pressure and pulse rate. These increases put additional strain on the heart.

Additionally, hormonal changes that come with the colder weather can make blood more conducive to clotting. Cortisone levels in the wintertime fluctuate with the colder weather, causing platelets to become ‘sticky”. These sticky platelets allow clots to form more easily. For people with known heart disease this can exacerbate their disease.  As the arteries constrict due to cold air, blockages become more severe.

While intense physical activity certainly puts a strain on the heart, cold weather is an exacerbating factor which leads to an increase in heart attacks and fatalities over the winter season.

Although many experts believe that colder temperatures cause heart attacks, if temperature is the sole factor then people who live at higher altitudes, where it is generally colder, should be more likely to die from heart attacks as well. Right? However, this is not the case.

Fact: Heart attacks are less common closer to the equator, less common in the summer, and less common at higher altitudes.

Fact: Vitamin D-UVB light is higher closer to the equator, higher in the summer, and higher at higher altitudes. So, lack of sunlight and Vitamin D deficiency may also play a role.

Finally, stress can certainly play a role. How else can we explain that the 3 riskiest days of the year to have a heart attack are: Christmas, the day after Christmas and New Years Day.

Some tips to keep your heart healthy

  • Keep Warm
  • Avoid prolonged exposure to cold temperatures if you are elderly,have heart disease or risk factors for heart disease like hypertension
  • Get some sun, but bundle up.
  • Exercise regularly. Join a gym or check out one of many exercise you tube videos
  • Do not shovel snow first thing in the morning
  • Warm up the body by marching in place before heading out to shovel snow
  • Stay hydrated
  • Do not drink alcohol or smoke before shoveling snow

Just remember, that with each passing winter day, the days get longer and summer gets closer.




Hit Your Health Goals for 2017

We all have them. What are your health goals for 2017? How will you accomplish them?


The first day of the first month of a new year invites us to set goals for the new year. Everyone wants good health, right? So, most people wish for health in the New Year. But we must do more than wish. Our health, our lives, are in our own hands. Let 2017 be the year of accountability. Take control of your health.

Starting point.  The first step in the process is to evaluate your current situation regarding your health and then ask yourself what you really want to achieve.

You can define your starting point by asking yourself:

  • What are your current health statistics – height, weight, Body Mass Index, blood pressure, cholesterol level, blood glucose, etc – how do these compare with normal measurements?
  • Do you exercise? How often and for how long?
  • Do you get enough sleep? Do you feel tired or do you have lots of energy?
  • What is your fitness level?
  • Do you have any bad eating habits – are you addicted to a particular food or type of food? Are you an ‘emotional’ eater? Do you eat enough?
  • Do you have any ailments that affect your health and wellbeing? Do you always seem to be run-down or picking up the latest cold or flu in town?
  • Do you often feel stressed?
  • Do you have any other bad habits that affect your well being – smoking? Alcoholism? Drugs?

Set goals. Set SMART goals. Simply saying that you want to lose weight, eat healthy, or stop smoking will likely result in failure.


Set a specific goal.A goal needs to be as specific as possible so you can work toward it and achieve it. “Lose weight”  or “Be Healthy” as a goal is too vague. What exactly do you want to achieve and how? Why do you want to do it? Do you want to feel better, have more energy, be happier, live longer?

Make goals measurable. If you don’ make your goal measurable, you don’t know when you’ve reached it. How much weight do you want to lose? What do you want your blood pressure to be? What about your cholesterol levels? How often should you exercise? Track your progress, write it down and celebrate the small successes along the way.

Be accountable. Keep a journal. Track your progress — your weight, your workouts, your food intake, how many cigarettes or drinks you had, your stress levels. There are many health apps out there that can be very helpful. Share your goals with a friend who can help keep you on track.

Set a realistic goal. Make it challenging yet not too overwhelming. Make it realistic for you based on your life, your schedule, your other commitments.

Set a timeframe. Timeframes should also be realistic. Don’t expect to lose 20 pounds in one month. Don’t expect to quit smoking cold turkey (although possible).

  • Allow yourself 1 week per kg (2 lbs) of weight you want to lose.
  • Allow yourself 3 months to get in to peak physical fitness.
  • Allow yourself at least 6 weeks to quit a habit like smoking, and maybe even longer for alcohol and drug dependency.

It may take up to 12 months to start ‘feeling’ healthy and energetic or overcome some other particular health ailments, again depending on your starting point. So hang in there! It is worth it.

Key to whatever your health goal is…eat mostly fruits and vegetables, get plenty of sleep (7-8 hours a night), exercise regularly and most importantly have compassion for yourself. Our goals are long-term and our good intentions are how we approach them everyday. Acknowledge that there will be days off track and celebrate the good days.



Mind-Body Medicine

I was truly honored to be invited to talk about Mind-Body Medicine at Sentara’s 25th Annual Critical Care and Trauma Symposium for nurses and guide some of the nurses through a “sunrise” yoga practice. When I was first approached, I was surprised because traditionally these critical care meetings focus on evidence based concepts for the critically ill patients, such as how to avoid infections, improve care of heart attack patients, etc. But after thinking about it for a minute, and then talking to Ashley (who invited me to speak), I realized that mind body medicine fits in perfectly.

Mind-Body Medicine is a medical discipline based upon the inseparable connection between the mind (which is not our brain, but our thoughts and emotions) and our physical health.


Unmanaged and overwhelming stress can turn into dysfunction and illness. So, we, the healthcare providers, need to embrace a holistic approach to our patients. The technological advances of the last century have been remarkable. No doubt, advancements in medical technology have allowed us to better diagnose and treat patients. Countless lives have been saved. But we are not meeting All the needs of our patients. As an interventional cardiologist, I am profoundly grateful for the technology at my hands which allow me to save lives and care for patients having a heart attack, acute heart failure, arrhythmias and cardiac arrest. But when I see them in the office a week or so after they’ve been discharged from the hospital, they are depressed, anxious and down right scared to death.

The use of complementary self-care modalities can help one manage stress and increase resilience. There is now significant evidence that mind-body therapies are beneficial in many medical situations, including heart disease. Mind-body therapies, in combination with conventional medicine, address the physical, emotional, and spiritual needs of patients. Such modalities include Yoga, Meditation, Relaxation, Art Therapy, Music Therapy, Dance Therapy, Taichi and Qigong.

These modalities can obviously be used by anyone & everyone for stress management and the prevention of illness. Stress does not affect only the sick. It affects all of us.


In the hospital setting, mind-body techniques can be utilized by 1) patients to reduce their pain and suffering, 2) family members to help them cope, and 3) healthcare providers to manage stress and increase empathy.

A little plug for my favorite mind-body therapy – Yoga. The popularity of Yoga has grown by over 50% in the last 8 years. According to the 2016 Yoga in America Study, 36.7 million Americans are practicing yoga with 80 million Americans likely to try yoga in 2016. One of the  most common reasons for starting yoga was stress relief. So, my hope is that more Americans, and especially healthcare providers,will incorporate Yoga into their daily routines as a way to manage their stress and stay Healthy.


Nurses at Sentara’s 25th Annual Critical Care and Trauma Symposium-A foggy sunrise yoga practice with dolphins


Staff at Sentara Cardiology Specialists practicing yoga after work


Maybe, this will be the norm in a few years!