With so many health products and practices promising to provide quick fixes to all that ails us, it can be difficult to discern which ones actually work. But for doctors and medical researchers, the question of effectiveness becomes an opportunity for clinical studies.
To find out more about some of these studies, “Take Care” spoke with Dr. Joann Manson, a professor of medicine at Harvard University, and chief of the Division of Preventive Medicine at Brigham and Women’s Hospital.
The division, Manson says, is currently working on two large-scale, randomized clinical trials. The first, called the “Vitamin D and Omega-3 Trial (VITAL),” was designed to observe whether vitamin D and omega-3 supplements have an effect on an individual’s risk for a number of chronic diseases (cancer, stroke, diabetes, etc.), with 26,000 men and women participating nationwide. Beginning in 2013, the trial will be complete after five years on December 31, 2017.
The second trial, known as the “Cosmos Trial,” is intended to test the preventative effects of cocoa flavonols (found in cocoa products) and multivitamins on various diseases, and will be underway once all 18,000 men and women necessary to conduct the study have been recruited.
So, who finds these participants? According to Manson, there are a number of recruitment methods, with mass mailings being one of the most successful. Using lists from health magazine subscriptions, neighborhood health centers, and hospitals, researchers typically seek out those with an interest in health, as they are likely the ones willing to participate in health-related trials. And naturally, it’s important for the subjects to reflect the demographics of the population, so Manson notes that in terms of race, ethnicity, body mass index, etc., the participants are generally representative of the entire population.
These trials are crucial because the results offer health professionals concrete evidence regarding whatever it is they’re testing, and therefore allow them to give reliable recommendations to their patients. For example, it is now widely accepted that estrogen therapy is the most effective treatment for hot flashes, night sweats, and other symptoms related to menopause, says Manson. And this wouldn’t be common knowledge in the medical field if it weren’t for the clinical trials that demonstrated estrogen therapy’s success.
Similarly, aspirin regimens are becoming more common, as research has suggested taking aspirin for at least 10 years may reduce the risk of colon cancer and other chronic diseases. However, Manson mentions that aspirin isn’t for everyone, and those who have a high risk of bleeding should steer clear. But if you don’t, and have a history (or increased risk) of cardiovascular diseases, you would likely be a candidate for aspirin based on the U.S. Preventive Services Task Force’s aspirin guidelines.
These guidelines are important, Mason remarks, because patients and their doctors should always assess the patient’s preexisting risk factors before taking a medication or supplement. Statins, for instance, are highly effective for some people, but certainly not all. Like aspirin, one must account for their risk, or lack thereof, of certain cardiovascular diseases. Using the risk calculator created by the American Heart Association, patients and doctors can decide if statins are the preventative option.
As always, Manson recommends a healthy lifestyle in general to achieve some of the results patients are seeking in their medication and supplements. If you are getting vitamin D through diet and direct sunlight, for example, you may not need to take it as a supplement, says Manson. With that said, if have bone health issues or simply don’t think you’re getting enough vitamin D, it’s not unreasonable, she says, to try taking vitamin D, but more often than not, the best medicine comes from the nutrients in our diet and healthy lifestyle choices.
