nother busy year for clinical
research has come and gone. What are the most important findings from 2019?
Here is our overview of some of the most noteworthy studies of the year.
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on PinterestWhat happened in medical research in 2019? In this special feature,
we summarize this year's top findings.
"Medicine is of all the Arts
the most noble," wrote the
Ancient Greek physician Hippocrates — whom historians call the "father of
medicine" — over 2,000 years ago.
Advances in therapeutic practices
have been helping people cure and manage illness since before the time of Hippocrates,
and, today, researchers continue to look for ways of eradicating diseases and
improving our well-being and quality of life.
Each year, specialists in all areas
of medical research conduct new studies and clinical trials that bring us a
better understanding of what keeps us happy and in good health, and what
factors have the opposite effect.
And, while each year, experts manage
to overcome many obstacles, challenges old and new keep the medical research
field buzzing with initiatives.
Reflecting on how research has
evolved over the past decade, the editors of the reputable journal PLOS Medicine — in a
recent editorial — emphasize "ongoing struggles" with infectious
diseases, as well as growing tensions between two approaches in medical
research. These approaches are the effort of finding treatments that are
consistently effective in large populations versus the notion of
"precision medicine," which favors therapy that we closely tailor to
an individual's very personal needs.
But how has clinical research fared
in 2019? In this special feature, we look at some of the most prominent areas
of study from this year and give you an overview of the most noteworthy
findings.
Friends or foes?
The medication we take — as long as
we follow our doctors' advice — is meant to help us fight off disease and
improve our physical or mental well-being. But can these usually trusty allies
sometimes turn into foes?
Most drugs can sometimes cause side
effects, but more and more studies are now suggesting a link between common
medication and a higher risk of developing different conditions.
In March this year, for instance,
experts affiliated with the European
Resuscitation Council — whose goal is to find the best ways to
prevent and respond to cardiac arrest — found that
a conventional drug doctors use to treat hypertension and angina may actually
increase a person's risk of cardiac arrest.
By
analyzing the data of more than 60,000 people, the researchers saw that a drug
called nifedipine, which doctors often prescribe for cardiovascular problems,
appeared to increase the risk of "sudden cardiac arrest."
Project leader Dr. Hanno Tan notes
that, so far, healthcare practitioners have considered nifedipine to be
perfectly safe. The current findings, however, suggest that doctors may want to
consider offering people an alternative.
Another study, appearing in JAMA Internal Medicine in June, found that
anticholinergic drugs — which work by regulating muscle contraction and
relaxation — may increase a person's risk of developing dementia.
People may have to take
anticholinergics if some of their muscles are not working correctly, usually as
part of health issues, such as bladder or gastrointestinal conditions,
and Parkinson's disease.
The research — that specialists from
the University of Nottingham in the United Kingdom led — looked at the data of
58,769 people with and 225,574 people without dementia.
It revealed that older individuals —
at least 55 years old — who were frequent users of anticholinergics were almost
50% more likely to develop dementia than peers who had never used
anticholinergics.
But, while common drugs that doctors
have prescribed for years may come with hidden dangers, they are, at least,
subject to trials and drug review initiatives. The same is not true for many
other so-called health products that are readily available to consumers.
Such
findings says the study's lead researcher, Prof. Carol Coupland,
"highlight the importance of carrying out regular medication
reviews."
In 2019, we have celebrated 50 years since someone first successfully sent a message
using a system that would eventually become the internet. We have come a long
way, and now, we have almost everything within reach of a "click and
collect" order.
This, unfortunately, includes
"therapeutics" that specialists may never have assessed, and which
can end up putting people's health — and lives — in danger.
In August, the Food and Drug
Administration (FDA) issued a warning against
an allegedly therapeutic product that was available online, and which appeared
to be very popular.
The product — variously sold under
the names Master Mineral Solution, Miracle Mineral Supplement, Chlorine Dioxide
Protocol, or Water Purification Solution — was supposed to be a kind of
panacea, treating almost anything and everything, from cancer and HIV to the flu.
Yet the
FDA had never given the product an official assessment, and when the federal
agency looked into it, they saw that the "therapeutic" — a liquid
solution — contained no less than 28% sodium chlorite, an industrial bleach.
"[I]ngesting these products is
the same as drinking bleach," which can easily be life threatening, warned
the FDA's Acting Commissioner Dr. Ned Sharpless, who urged people to avoid them
at all costs.
The heart and its tributaries
Many studies this year have also
been concerned with cardiovascular health, revisiting long held notions and
holding them up to further scrutiny.
For instance, a study in the New England Journal of Medicine in July —
which involved around 1.3 million people — suggested that, when it comes to
predicting the state of a person's heart health, both blood pressure numbers
are equally important.
When a doctor measures blood
pressure, they assess two different values. One is systolic blood pressure,
which refers to the pressure the contracting heart puts on the arteries when it
pumps blood to the rest of the body. The other is diastolic blood pressure,
which refers to the pressure between heartbeats.
So far, doctors have primarily taken
only elevated systolic blood pressure into account as a risk factor for
cardiovascular disease.
However, the new study concluded
that elevated systolic and diastolic blood pressure are both indicators of
cardiovascular problems.
Its authors emphasize that the large
amount of data they had access to painted a "convincing" picture in
this respect.
"This research brings a large amount of data to bear on
a basic question, and it gives such a clear answer."
Lead researcher Dr. Alexander Flint
At the same time, a slightly earlier
study, appearing in the European Heart Journal in March,
emphasizes that having high blood pressure may
not mean the same thing for everyone, and while doctors may associate it with
adverse outcomes in some, this does not hold for all populations.
The study's first author, Dr.
Antonio Douros, argues that "[w]e should move away from the blanket
approach of applying the recommendations of professional associations to all
groups of patients."
Dr. Douros and team analyzed the
data of 1,628 participants with a mean age of 81 years. The researchers found
that older individuals with lower systolic blood pressures actually faced a 40%
higher risk of death than peers with elevated blood pressure values.
"[A]ntihypertensive [blood
pressure lowering] treatment should be adjusted based on the needs of the
individual," the study's first author advises.
When it
comes to protecting heart health, 2019 studies have shown that diet likely
plays an important role. Thus, research in the Journal of the American Heart Association in
August showed that people who adhered to plant-based diets had a 32% lower risk
of death that researchers associate with cardiovascular disease than those who
did not.
People who ate plant-based foods
also had a 25% lower risk of all-cause mortality, according to this study.
And another study — from April in
the journal Nutrients — warned
that people who follow a ketogenic diet, which is high in fats and low in carbohydrates, and who
decide to take a "day off" from this commitment every now and again,
may experience blood vessel damage.
Ketogenic — or keto — diets work by
triggering ketosis, a process in which the body
starts burning fat instead of sugar (glucose) for energy. But "cheat
days" mean that, for a brief interval, the body switches back to relying
on glucose.
"[W]e found [...] biomarkers in
the blood, suggesting that vessel walls were being damaged by the sudden spike
in glucose," notes first author Cody Durrer.
Our diets, ourselves
In 2019, the topic of how our food
choices influence our health has remained popular among researchers and readers
alike.
And this year's studies have
certainly reflected the widespread interest in the link between dietary choices
and well-being.
One intriguing study — in Nature Metabolism in May — pointed out that
protein shakes, which are popular among individuals who want to build muscle
mass, may be a threat to health.
Fitness protein powders, the study
authors explain, contain mostly whey proteins, which have high levels of the
essential amino acids leucine, valine, and isoleucine.
The research — in mice — suggested
that a high intake of these amino acids led to overly low levels of serotonin in the
brain. This is a key hormone that plays a central role in mood regulation, but
which science also implicates in various metabolic processes.
In mice,
the heightened levels of leucine, valine, and isoleucine, which caused
excessively low serotonin, led to obesity and a shorter life span.
So, if too much of certain types of
protein can have such detrimental effects on health, what about fiber? Dietary fiber —
present in fruit, vegetables, and legumes — is important in helping the body
take up sugars little by little.
But how much fiber should we
consume? This is the question that a study commissioned by the World Health
Organization (WHO) — and appearing in The Lancet in January — sought to lay to
rest.
The research took into account the
findings of 185 observational studies and 58 clinical trials, covering almost
40 years.
It
concluded that to lower their death risk, as well as the incidence of coronary
heart disease, stroke, type 2 diabetes, and colon cancer, a person should
ideally consume 25–29 grams of fiber per day.
"Fiber-rich whole foods that
require chewing and retain much of their structure in the gut increase satiety
and help weight control and can favorably influence lipid and glucose
levels," explains one of the authors, Prof. Jim Mann.
On the other hand, several studies
from this year draw attention to just how detrimental foods that are not 100%
natural can be. A small trial, whose results came out in Cell Metabolism in May, showed that processed
food leads to abrupt weight gain — but not for the reasons we may think.
The study authors said they were
surprised that when they asked participants to eat either an ultraprocessed
food diet or a nonprocessed food diet — whose caloric contents the researchers
matched perfectly — the people who ate processed foods rapidly gained more
weight than the ones who ate the nonprocessed foods.
The researchers blame this on the
speed with which individuals end up eating processed foods, in particular.
"There may be something about the textural or sensory properties of the
food that made [participants] eat more quickly," says study author Kevin
Hall, Ph.D.
"If
you're eating very quickly, perhaps you're not giving your gastrointestinal
tract enough time to signal to your brain that you're full. When this happens,
you might easily overeat," he hypothesizes.
And more research in mice —
from Scientific Reports in January — found that
emulsifiers, which are a common additive present in many products from
mayonnaise to butter, could affect gut bacteria, leading to systemic inflammation.
What is more, the impact on the gut
could even influence processes that occur in the brain, increasing anxiety levels.
"[W]e [now] know that inflammation triggers local immune cells to produce
signaling molecules that can affect tissues in other places, including the
brain," explains co-lead researcher Prof. Geert de Vries.
While some of the studies that made
the headlines in 2019 were conclusive, many encourage further research to
confirm their findings or further investigate the underlying mechanisms.
Stepping into the next decade, this
much is clear: The wheels of medical research will keep on turning for better
health across the globe.
Source: MedicalNewsToday
