Medical advances that may affect your health

The past 24 months brought a number of important medical advances from research centers all over the world. Here are some of what I consider to be the most important ones, as reprinted from scientific medical journals over the past two years.

Stroke Rehabilitation

More people than ever before are surviving a stroke, but many patients experience permanent neurological damage, which often includes partial or complete paralysis of one or more limbs. In the last few years, Pablo Celnik, MD, director of the Human Brain Physiology and Stimulation Laboratory at Johns Hopkins Medical Center in Baltimore, and his team have been testing transcranial direct current stimulation (tDCS) therapy, which may help stroke victims regain movement.

tDCS, which is noninvasive and painless, delivers continuous low-level electrical current to the brain’s frontal cortex, the region governing motor functions. While undergoing tDCS, patients perform a motor skill they had lost, such as the ability to grasp an object.

“Patients often improve by simply repeating a task over and over,” explains Dr. Celnik. “But with the addition of tDCS, improvements are larger than when motor rehabilitation and electrical stimulation are used separately — and gains tend to happen more quickly. We think this is because stimulation helps the brain function more efficiently.”

The therapy may also be able to help people with traumatic brain injuries and neurological conditions such as Parkinson’s disease and age-associated motor deficits. One study, co-authored by Celnik, found that older adults receiving tDCS were capable of performing hand movements as quickly as young adults. Although brain stimulation therapy is not yet available outside the lab, and long-term studies need to be completed, Dr. Celnik says we might see tDCS in rehab clinics within the next five years.

Healthy diet for weight loss

Trying to shed extra pounds? Researchers from Harvard School of Public Health and Brigham and Women’s Hospital, along with those from other institutions, found that the type of diet you use is not the important element. What’s key is finding a healthy diet you are most likely to stick with.

The two-year study, published in the The New England Journal of Medicine, assigned 811 overweight or obese adults to one of four different diets: low-fat, average protein; low-fat, high-protein; high-fat, average-protein; or high-fat, high-protein. Participants were asked to reduce their dietary cholesterol, increase their fiber intake, and consume less than eight percent of calories from saturated fat. All the diets contained similar foods, and researchers recommended that study subjects complete 90 minutes of moderate exercise each week. Participants also kept track of what they ate and attended nutritional and motivational counseling sessions.

At the end of the study, researchers found that participants in all four groups lost an average of 8.8 lbs. each and had similar levels of satisfaction with their respective diets. This study proves that calorie reduction and moderate exercise, along with lifestyle modifications, are paramount for weight reduction that is sustainable. So, pick a diet you’re comfortable with, making sure you receive adequate nutrients and are committed to the effort. Consider seeing a nutritionist or joining a weight-loss group to promote your efforts.

More benefits from statins

In 2008, the JUPITER trial found that people with normal low-density lipoprotein (LDL) cholesterol but high C-reactive protein levels — linked to higher risk of heart attack and stroke — who took rosuvastatin (Crestor) were less likely to have a heart attack or stroke than those participants who took placebo. In 2009, results from the DECREASE III trial provided evidence of other benefits.

DECREASE looked at 497 people who underwent vascular surgeries such as aortic aneurysm repair. During surgery, the body tends to unleash inflammatory proteins that can rupture plaques, causing blood clots that can lead to a heart attack or stroke. DECREASE aimed to determine whether statins might reduce the likelihood of such complications.

Participants were randomly assigned to take fluvastatin (Lescol) or placebo from the time they enrolled in the study to one month after their surgical procedure. All patients took a beta-blocker. Those taking fluvastatin were 45 percent less likely to experience diminished blood flow to the heart and 53 percent less likely to die of a heart attack or stroke than those in the placebo group. It seems that cholesterol lowering is only one of the many benefits of statins for patients with vascular disease. DECREASE further suggests that while there has been great emphasis on the benefits of taking beta-blockers before and after vascular surgery, statins may be as valuable — if not more so.

D one and only

Vitamin D, which your body creates through sun exposure, helps you absorb calcium and prevents the brittle-bone disease osteoporosis. But with a host of new research linking vitamin D deficiency to other conditions, the nutrient’s potential benefits have multiplied.

A European study of 752 women aged 75 and older, published in the journal Neurology, found that participants with low vitamin D levels performed worse on cognitive function tests than those with normal vitamin D levels. Another study of 3,400 men and women 65 and older, published in the Journal of the American Geriatric Society, found that participants with vitamin D deficiency were three times more likely to die of coronary heart disease than those with adequate levels of the vitamin. Other studies have linked vitamin D deficiency to some cancers.

As you age, your skin becomes less adept at converting ultraviolet light from the sun into vitamin D. Ask your doctor for a blood test to check your vitamin D levels. If deficient, take a supplement and aim for 800 IU of vitamin D a day.

Calorie-burning fat?

Visceral fat, the fat located in our abdomen, churns out inflammatory factors and hormones. By comparison, the subcutaneous fat, which lies under the skin, is metabolically sedate. Findings published last year further implicate visceral fat as a source of health woes, which largely exonerates the subcutaneous deposits. For example, Framingham Heart Study researchers reported that visceral, not subcutaneous fat, was associated with calcium deposits, a marker for atherosclerosis, in the body’s main artery, the aorta.

White fat cells store fat, and most of the fat in our bodies — visceral and subcutaneous — is white fat. But there are also brown fat cells that actually burn fat. We have brown fat as newborns to help with regulation of body heat, but it’s long been believed that it soon disappears. A surprising trio of articles published in The New England Journal of Medicine last year used PET scans to show that we actually retain appreciable amounts of brown fat as adults in an area between the shoulder blades, and that the more brown fat an adult has, the more likely he or she is to be lean with healthy metabolic indicators.

Researchers are now studying how brown fat cells can be increased or activated. The visceral fat findings are shifting attention to waist size as a measure of obesity, although it is not so simple: Subcutaneous fat also contributes to waist size especially in women. Still, the notion that diet and other habits should be judged by their effect on waist circumference is gaining ground.

What’s next? Researchers say more studies are needed to examine the effects of cold, weight-loss diets, and increased exercise on brown fat activity.

Meanwhile, progress in medicine marches on in all spheres — prevention, treatment, and rehabilitation. This new century will witness great strides in health care unparalleled in history — with people living longer and better lives!