The Year in Medical Breakthroughs
Science has always fascinated me. The stack of medical journals in my living room is formidable, and I can easily be lost for hours in articles about genes and mitochondria. But there's a difference between the frontiers of science and the frontiers of health. The former has theoretical relevance. It may translate into medical breakthroughs in the future. The latter is more immediate. It includes information that can affect our lives and the way we decide to live them.
We're bombarded with "medical miracles" every time we turn on the news or read the paper. What's meaningful and what's hyperbole? Of the stories that broke this year, here are the ones I think will affect our approach to health for years to come.
Better Screening for Women's Heart Health
Earlier this year, the Journal of the American Medical Association reported the development of the Reynolds Risk Score, an updated set of criteria physicians can use to identify more accurately women who are at risk of cardiovascular disease and would benefit from aggressive preventive treatment. Why is this noteworthy?
Up to 20 percent of women who suffered heart attacks didn't have any of the risk factors (including high cholesterol and high blood pressure) that have traditionally been used to predict cardiac events. I hope we'll see that percentage decrease as many more women who might not have been identified as at-risk in years past are able to take charge of their health.
Scientists have known since the late 1990s that there is a link between C-reactive protein (an indicator of inflammation in the body) and heart disease. But when they took a closer look at the data, they were surprised to learn that elevated levels of the protein predicted heart disease in women who did not have other risk factors. The Reynolds Risk Score, which was developed by researchers at Brigham and Women's Hospital in Boston, takes C-reactive protein levels into account.
The score also factors into its calculations a woman's hereditary risk and, in patients with diabetes, hemoglobin A1c levels, a measure of how well blood sugar is being managed. If you have blood-work results from a recent doctor visit, you can calculate your score at www.reynoldsriskscore.org. Get your doctor to clarify anything you find out. And if you haven't had an hsCRP (high-sensitivity C-reactive protein) blood test yet, ask your doctor if you need one.
Vitamin D Delivers
In 2007, vitamin D was found to:
- Potentially prevent up to half of breast cancer cases
- Possibly prevent two-thirds of colon cancer cases
- Reduce the risk of preeclampsia during pregnancy
- Increase physical performance in people over age 60
- Prevent weight gain in postmenopausal women
- Boost the immune system enough to fight off tuberculosis and similar bacteria for at least six weeks
- Have therapeutic potential in the management of multiple sclerosis
Of course, the vitamin's role in maintaining bone health and preventing osteoporosis has been well documented for years. Does all of this make D the new super vitamin? We have a habit in this country of running to the health store and stockpiling the goods whenever we hear great news about a nutrient. I'm not advising that. But when you make a list of questions to bring to your first doctor visit of 2008, ask if your "serum 25-hydroxyvitamin D levels" have been measured lately.
Although it's present in dietary supplements and some foods, including salmon and fortified milk, vitamin D is largely produced by our bodies when we're exposed to sun. Scientists say just ten minutes of sunlight daily is sufficient. For one thing, skin cancer is still a reality. For another, excessive sun doesn't always translate into more vitamin D. In one study of 93 Hawaiian residents exposed to several hours of sun a week, more than half were still deficient in D. As always, more research needs to be done.
Surgery Without a Scar
Late last year, doctors in the Department of Surgery at Ohio State University Medical Center became the first in the country to use a revolutionary new surgical technique for abdominal procedures called NOTES, or Natural Orifice Translumenal Endoscopic Surgery. That's the technical way to describe operations in which a surgeon enters a patient's body through natural openings, such as the mouth, nose, vagina, or rectum, rather than by making the usual incisions from the outside. The technique leaves virtually no visible scarring.
Other potential benefits are reduced recovery time, less patient discomfort, and a lower incidence of infection. In 2007, more hospitals got into the act, and additional successful operations were reported. In April, surgeons at Columbia University Medical Center performed a gallbladder operation via the patient's vagina. In June, doctors at Baystate Medical Center, in Springfield, Massachusetts, removed a pancreatic cyst by entering the patient's body through the mouth.
A City Bans Trans Fats
New York City is the first major municipality in the country to issue a ban on trans fats -- the kind of fat most detrimental to our health -- in all restaurants. Since the announcement was made, politicians in Philadelphia, Chicago, and the state of California have pushed for similar measures. (If you want to start a movement in your own area, go to www.bantransfats.com.)
New York City's Board of Health also required some restaurants to display the calorie content of each item prominently, either on menu boards or near cash registers. A federal judge struck down the rule on the grounds that it singled out certain establishments, but similar legislation is pending in fourteen states. Are such legal measures necessary? That's up for debate. But if the publicity surrounding these stories makes us more thoughtful about what we eat and how much -- great.
Advances in Brain Science
In medicine, there's nothing that seems so unknown, so unimaginably complex, as the human brain. This year brought us ever closer to unlocking its mysteries. The National Institutes of Health embarked upon the Magnetic Resonance Imaging Study of Normal Brain Development, which will use MRI technology to understand how a normal brain develops, and then use those findings to shed light on brain abnormalities in children.
The research is also giving us the power to understand Alzheimer's disease, providing us with detailed information about its course. Just as incredible, advanced imaging studies are being used to map the brain, giving us insight into which parts are responsible for the decisions we make and the actions we take.
Exercise: It's All Good
In May, researchers at Louisiana State University found that even as little as 75 minutes of exercise a week improved cardio-respiratory function in postmenopausal women who are sedentary and overweight. So it's true: Every little step counts.
If you're already engaged in an exercise program, even better. This isn't a justification to cut back: Thirty minutes or more of exercise a day is still the best plan. But if you've been having trouble getting started, remember that any exercise you do is always better than no exercise at all. I could fill this whole magazine with more news, but then there wouldn't be room for articles about all the other things we hope you'll stay healthy enough to do. You can read about other stories I thought were important at marthastewart.com/health. I'm already looking for findings that are going to make us healthier in '08. I've got my reading chair--and a spot next to it for a new stack of journals.
Text by Brent Ridge, M.D.