Latest Medical Research
Recent medical research studies that impact the way Health HQ doctors treat their patients.
Latest medical research (PDF) documents
Click if you need to download the Adobe reader.
See PDF of JACI article Dr Pete Smith et al The false alarm hypothesis: Food allergy is associated with high dietary advanced glycation end-products and proglycating dietary sugars that mimic alarmins
Dr Norman Hohl believes this is a very important study and wrote:
On Tue 14 Nov 2017 I was very privileged to hear Dr Pete Smith BMedSci MBBS FRACP PhD (who is a leading allergist and immunologist currently working in Southport) explain in detail his hypothesis on the cause of the recent marked rises in food allergies in children and many degenerative and/or autoimmune diseases in adults including diabetes, atherosclerosis, chronic kidney disease, and Alzheimer's disease
His “false alarm” hypothesis was published in the Journal of Allergy and Clinical Immunology (JACI) in February 2017, see the original article (PDF).
The high regard for its scientific validity resulted in Dr Smith being asked to speak on the 27 Oct 2017 in London at a Plenary session of the annual European Academy of Allergy and Clinical Immunology (EAACI) which is the largest medical association in Europe in the field of allergy and clinical immunology and has over 9,000 members from 121 countries.
A quick summary of extracts of his hypothesis is that our Western diet is sending a false alarm to our immune system causing it to regard normal good foods such as nuts, eggs and milk as dangerous which causes an allergic reaction.
The Western diet contains food which is high in what are called “AGE products” which stands for Advanced Glycation End-products. This false alarm signal is markedly aggravated by proglycating dietary sugars, particularly fructose.
Eating whole fruit with fructose is fine but drinking fruit juice is very bad, especially apple juice.
These AGE products are mainly produced in high amounts by animal proteins and oils/fats cooked at high temperatures. This happens particularly with frying and micro-wave cooking.
Sugars are bound to proteins or fats forming AGE products which are also called glycotoxins.
The best characterised of these AGE products is a cancer causing agent which is capable of causing damage to our DNA.
Dr Smith proposes that fructose is a key substrate for this agent when eaten together with these AGE products which are produced by cooking meat in fat at high temperature.
Serum uric acid levels are a predictor of fructose toxicity. This plays a key role in causing peanut allergy.
Dr. Smith explained that “Our diet is high in AGEs, which are largely derived from cooked meats, oils and cheese.”
Microwaving whole milk (which is low in AGEs) increases AGE production 5 fold at 1 minute and 86 fold at 3mins.
Converting whole milk into dry powdered milk increases AGE production by 670 fold!
In the USA sugar intake (especially fructose) has increased dramatically over the last 50 years as has potato consumption, mostly as French fries. This is the most common vegetable eating by 2-4yr olds now.
90% of 3-4yr olds have fructose food every day.
The good news is that probiotics degrade AGEs as do dietary flavonoids found in green tea, apples & soy products.
The following three research studies are all concerned with evidence pertaining to better ways to lose weight.
Intermittent dieting works best
Avoiding continuous dieting may be the key to losing weight and keeping it off, say nutrition scientists, furthermore they believe that traditional intermittent fasting regimens such as the popular 5:2 diet are not the way to go about losing weight.
Read the summary of the study as well as the research here Intermittent dieting works best (PDF).
Walnuts reduce hunger
This study published in a journal called Diabetes, Obesity and Metabolism concludes that Walnut consumption decreased feelings of hunger and reduced appetite. The study used brain imaging to assess what happens in the brain after consuming walnuts vs control group's brains. This is a fascinating study with the easiest take away - eat some walnuts to control your hunger!
Read the summary of the study entitled Nutty approach to diabetes and obesity (PDF).
Nonnutritive sweeteners and cardiometabolic health
This massive study of people who use artificial sweeteners is frightening in it's implications for Australians.
Collectively Australians consume a huge amount of artificial sweeteners such as aspartame (nutrasweet), sucralose and stevioside.
Dr. Harlan Krumholz, editor-in-chief of NEJM Journal Watch Cardiology, comments: “This study raises the concerning possibility that not only have these sweeteners not helped people manage their weight, but may have actually jeopardized their cardiometabolic health.”
Read the summary of the study entitled Artificial Sweeteners Not Tied to Lower BMI, May Even Increase It (PDF).
Also see original study online.
Of the 2 studies immediately below Dr Hohl has said “They both reinforce our fundamental message that healthy lifestyle reduces the risk for some of the most prevalent and serious risks to our health.”
Healthy lifestyle helps avoid Cancer
Around 20% to 40% of cancer cases and about half of all cancer deaths can potentially be avoided by making modifications in lifestyle, according to new findings.
After investigating cancer risk among a portion of the US white population, the authors of a large cohort study concluded that a large proportion of cancer cases and related mortality could be prevented if people did not smoke, drank only a little alcohol, maintained a healthy weight.
Read the 3 page summary of the study entitled Lifestyle Changes Can Dramatically Cut Cancer Incidence (PDF).
Also see original study online.
Cardio Fitness reduces risk of Atrial Fibrillation
More research shows that cardiorespiratory fitness is associated with a progressively lower risk of atrial fibrillation (AF) — this time in middle-aged men with diabetes mellitus or hypertension.
Read the 2 page summary report entitled AF Risk Plunges With Improving Cardio Fitness in Patients With Hypertension or Diabetes (PDF)
Below are Dr Hohl's comments on the important questions "Is Ovarian Cancer screening worth it?"
"This 14yr study from UK has finally shown that the blood tests we have been doing for years, Ca125+HE4 (ROMA), DO actually reduce deaths from Ovarian cancer, albeit only 20% in those who did not have a cancer already present found on enrolment. (i.e. the true screening of those with no cancer to start with) You will note, that some of the women were only screened for 6yrs (2005-11), which is not long for such a cancer so I expect the benefit will be greater the longer a women is screened for as this study shows in the difference in time to death. Only 8% reduction in deaths in years 0-7, but 28% reduction in years 7-14.
- See a summary of the ovarian cancer screening research (PDF) entitled Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial.
See also summary at PubMed from orginal published in Lancet March 2016.
Revisited May 2016
Dr Hohl believes the recent research on better high blood pressure management (below) is incredibly important. It supports his and many other GP's views on best practice management of hypertension (high blood pressure).
- The 2015 High Blood Pressure treatment research (see below) which showed intensive management with lower BP targest is best for survival is now backed up by Australian researchers in 2016.
Read a summary of the 2016 Australian meta analysis of the efficacy of so-called "intensive" blood pressure management strategies (which have a lower BP target range).
Below is a summary of the 2015 UK research with supporting documents including the full text of the study.
The debate that has raged about the target systolic blood pressure is over with new evidence presented in a U.S. blood pressure study by the National Institues of Health (NIH).
Summary: Getting the systolic blood pressure down to 120 mm Hg has been proven to reduce the rate of heart attack, heart failure, and stroke by almost a third and to reduce the risk of death by almost a quarter when compared the higher target of 140 mm Hg.
Health HQ principal Dr Norman Hohl believes that "A lot of recent medical experts have been saying there is no benefit in lowering the blood pressure target to than less than 140 (systolic). This proves them WRONG"
Read the study (PDF) A Randomized Trial of Intensive versus Standard Blood-Pressure Control
See more basic information on defining blood pressure, systolic and diastolic readings and what is normal and abnormal.
Food allergy research revisited May 2016
Dr Hohl commented that "this [earlier] article, with validity confirmed by ‘Evidence Updates’ reviewers, will be of interest to many of our patients. It correlates with the recent articles linking early exposure to nuts reducing allergies."
See summary of research entitled Gluten Introduction to Infant Feeding and Risk of Celiac Disease: Systematic Review and Meta-Analysis (PDF).
Below are Dr Hohl's earlier comments on the important food allergy research which follows.
"This article (summary below) supports other recent studies suggesting the early introduction of common allergenic foods, reduces the development of food allergy.
We need to note specifically the ‘per-protocol’ results, i.e. for the parents who actually followed the protocol of introduction of all the foods at 3/12 old versus those at 6/12. Overall allergy development was 2.4% v 7.3%. Of particular interest was that peanut allergy 0% v 2.5%, and egg allergy 1.4% v 5.5%.
1303 babies in the study in total so a meaningful sized cohort, but note in the editorial that only 43% in the early introduction group were able get their children to eat all 5 foods as per protocol. Some of these foods can be difficult to get 3/12 olds to eat.
Results still worthy of consideration, as confirmed by the repeat publication of this abstract by “Evidence Updates” which only publishes after new articles have been further reviewed by an independent panel for validity and relevance. "
Perkins MR, Logan K, Tseng A, et al.
Randomized Trial of Introduction of Allergenic Foods in Breast-fed Infants.
N Engl J Med. 2016 Mar 4. (Original) PMID: 26943128
The age at which allergenic foods should be introduced into the diet of breast-fed infants is uncertain. We evaluated whether the early introduction of allergenic foods in the diet of breast-fed infants would protect against the development of food allergy.
We recruited, from the general population, 1303 exclusively breast-fed infants who were 3 months of age and randomly assigned them to the early introduction of six allergenic foods (peanut, cooked egg, cow's milk, sesame, whitefish, and wheat; early-introduction group) or to the current practice recommended in the United Kingdom of exclusive breast-feeding to approximately 6 months of age (standard-introduction group).
The primary outcome was food allergy to one or more of the six foods between 1 year and 3 years of age.
In the intention-to-treat analysis, food allergy to one or more of the six intervention foods developed in 7.1% of the participants in the standard-introduction group (42 of 595 participants) and in 5.6% of those in the early- introduction group (32 of 567) (P=0.32).
In the per- protocol analysis, the prevalence of any food allergy was significantly lower in the early-introduction group than in the standard-introduction group (2.4% vs. 7.3%, P=0.01), as was the prevalence of peanut allergy (0% vs. 2.5%, P=0.003) and egg allergy (1.4% vs. 5.5%, P=0.009); there were no significant effects with respect to milk, sesame, fish, or wheat.
The consumption of 2 g per week of peanut or egg-white protein was associated with a significantly lower prevalence of these respective allergies than was less consumption. The early introduction of all six foods was not easily achieved but was safe.
The trial did not show the efficacy of early introduction of allergenic foods in an intention- to-treat analysis.
Further analysis raised the question of whether the prevention of food allergy by means of early introduction of multiple allergenic foods was dose dependent.
(Funded by the Food Standards Agency and others; EAT Current Controlled Trials number, ISRCTN14254740 .)
See also Editorial (2 page PDF) - Preventing Food Allergy in Infancy — Early Consumption or Avoidance? by Gary W.K. Wong, M.D.
See also the complete study by Perkins MR, Logan K, Tseng A, et al. that is summarised above, (11 page PDF) see Randomized Trial of Introduction of Allergenic Foods in Breast-Fed Infants.
- DABIGATRAN COMPARES FAVOURABLY WITH WARFARIN
Large real-world study compares dabigatran with warfarin
The risk of haemorrhage in older patients with atrial fibrillation (AF) is significantly lower with dabigatran than with warfarin, according to a real-world study from New Zealand's University of Otago.
Researchers looked at almost 5,000 AF patients on dabigatran and a similarly sized matched cohort on warfarin. They found an annual incidence for any haemorrhage of 5.1% with dabigatran and 11.8% with warfarin. The incidence rate for intracerebral haemorrhage (ICH) was also substantially lower in dabigatran users (0.18%) compared with warfarin (0.53%).
The researchers also found no increased gastrointestinal (GI) bleeding with dabigatran, in contrast to several earlier large observational studies. Overall mortality over the study period was 28% lower with patients on dabigatran compared with warfarin.
One of five ICHs was fatal in dabigatran users, compared with six of 13 ICHs in the warfarin group. Risk factors for haemorrhage in both groups included extreme age (over 85), heart or liver failure, peripheral vascular or pulmonary disease and cancer. The overall risk of haemorrhage did not differ between patients on 150mg compared with 110mg dabigatran, although a subgroup aged 75-84 years had a higher incidence with the larger dose.
"The observed lower overall bleeding risk for dabigatran than for warfarin and differing risk of different drugs and doses with age should be considered when prescribing anticoagulation therapy for older people with atrial fibrillation"
the researchers write in the International Journal of Cardiology Volume 203 Pages 746–752 January 15 2016.
Unusually for a study of one of the new oral anticoagulants, the authors declared no conflicts of interest or any ties with pharmaceutical companies.
- MASSAGE NO HELP FOR SHOULDER PAIN
Conclusion: The addition of soft tissue massage to an exercise program for the shoulder conferred no additional benefit for improving pain, disability, or range of motion in people with nonspecific shoulder pain.
See research summary in Journal of the American Physical Therapy Association
- TRY ACUPUNCTURE OR ALEXANDER TECHNIQUE FOR CHRONIC NECK PAIN
Acupuncture sessions and Alexander Technique lessons both led to significant reductions in neck pain and associated disability compared with usual care at 12 months. Enhanced self-efficacy may partially explain why longer-term benefits were sustained.
See research summary in Annals of Internal Medicine
- INTERVENTION PREVENTS ANXIETY ONSET IN CHILDREN OF ANXIOUS PARENTS
A brief family-based psychosocial prevention program holds promise for reducing the 1-year incidence of anxiety disorders among offspring of anxious parents.
See research summary in The American Journal of Psychiatry
- MENSTRUAL MIGRAINE RESEARCH
Menstrual migraines are both common and debilitating for many women. This newest best evidence shows that taking a triptan medication is the best way to treat and prevent menstrual migraines.
See research abstract.
More information about Triptans medication.
- ALCOHOL CAUSES HIGHER RISK OF CANCER
A recently published large, high-quality, long-term study has evaluated light to moderate alcohol intake independently of smoking and found that for women, even one alcoholic drink per day significantly increases the risk of some types of cancer. For men who have ever smoked, up to two drinks per day significantly increases the risk, as well.
The luckiest group studied is men who have never smoked who can consume up to 2 drinks per day with no increased cancer risk!
Link to research summary published in the British Medical Journal (BMJ)
See entire research article (8 page PDF - 436KB). The research was conducted in the U.S.
- LIFESTYLE MODIFICATION CAN PREVENT DIABETES IN AT RISK PATIENTS
A recent study involving 3000 participants who were at risk of developing diabetes, studied the outcome of lifestyle changes, Metformin therapy and placebo. After 3 years it was shown that those participants at both high and low risk of developing Diabetes significantly reduced their risk by 28.3% and 4.9% respectively. Metformin therapy was really only of benefit in the group with the highest risk factor.
Full article in BMJ
Related background research study published in The Lancet
- ORAL PROPRANOLOL SUCCESSFUL IN TREATING INFANTILE HEMANGIOMA
Of 456 infants (aged between 1-5 months) who received oral Propranolol to treat Infantile Hemangioma (benign vascular tumours),a huge 88% showed significant improvement by week 5 as opposed to 5% of infants who received a placebo
Full article in New England Journal of Medicine (NEJM)
- PREVENAR 13 PROVES TO BE EFFECTIVE IN PREVENTING PNEUMONIA AMONGST ADULTS AGED 65+
Prevenar has long been proven to be most effective in preventing pneumococcal disease in babies and children. Evidence for the effectiveness of the vaccine in older adults has now been released. In a world first, randomised double blind, placebo controlled trial which involved nearly 84 500 adults, the Prevenar 13 vaccine proved it was most effective in preventing vaccine type pneumococcal, bacteremic and non bacteremic community acquired pneumonia and vaccine type invasive pneumococcal disease.
See abstract in NEJM
- HORMONAL CONTRACEPTIVES HAS BEEN SHOWN TO INCREASE RISK OF GLIOMA
Although brain tumours in young women are rare, a link between the use of hormonal contraceptives and glioma (or brain tumour) in young women has now been confirmed. This is according to the British Journal of Clinical Pharmacology. Danish researchers matched over 300 women aged between 15-49 who had a glioma with over 2000 women without glioma. The odds ratio for glioma and hormonal contraceptives was 1:5. Progesterone only contraceptives particularly increased the risk. In addition, those who were current or recent users of hormonal contraceptives also had an increased risk of glioma more than past users. Full article see:
- PREVENTATIVE PROGRAMS TO DECREASE CARDIOVASCULAR INCIDENTS PROVE HIGHLY SUCCESSFUL
Dedicated community programs to significantly improve cardiovascular health have proved particularly successful in the United States – specifically in Maine. A comprehensive forty year study in this county which had a consistent and dedicated program to reduce cardiovascular incidents was completed. The study showed that this county of Maine saved over $5.7 million a year on hospital admissions in relation to cardiovascular disease. In addition the rates of improved cardiovascular health was significantly better then state averages across the United States.
For more information see JAMA article.
- TRAVELERS TO THE UNITED STATES SHOULD BE IMMUNISED AGAINST MEASLES
Disneyland in California has been identified as a possible cause of an outbreak of Measles which initially infected 40 people who visited or worked at Disneyland in Dec 2014.
Since then over 100 people in California have contracted the measles as well as people across four American states.
Measles can prove deadly to adults – especially those whose health is already compromised.
All travellers to the United States of America should visit their travel health doctor to ensure their Measles’ immunity is current. The recommended two dose of Measles’ vaccine is 99% effective in preventing the disease. Measles’ outbreaks over the world have been reported in recent years including Vietnam, Philippines and Western Europe.
Travellers please contact Health HQ Southport on 5526 4444.
See Center for Disease Control website regarding Measles outbreak.
See also California Dept of Public Health website regarding Measles outbreak.
- CRUISE SHIP TRAVELLERS AND THOSE DEPARTING TO THE US ARE ADVISED TO GET FLU VACCINE AND SHOULD CARRY TAMIFLU - Travellers to the United States, and those going on cruise ships anywhere in the world, should get the influenza vaccine and carry Tamiflu. Current (Jan 2015) ‘Flu and Pneumonia cases in the US have now reached epidemic levels. Nearly 7% of deaths including 15 children were reported the week ending December 2014.
For full article please click on CDC health advisory also see CDC news conference transcript.
THREE DOSES OF THE HPV VACCINE IS NEEDED TO ENSURE LIFE LONG PROTECTION - Although two doses of the HPV vaccine reduces substantially the risk of HPV related cancers, patients still require 3 doses to ensure lifelong protection.
For full article please click on BMJ article
- NEW ANTIBIOTIC, TEXIOBACTIN IS DISCOVERED - What might be a revolutionary antibiotic has been discovered. Texiobactin is being tested on mice and is showing promising results against gram negative pathogens including Multiple Resistant Stapholccous Aureus (MRSA). Ground-breaking properties so far indicates an ability to avoid resistance.
See full article in Nature
Also see New York Times story
- DIETARY FIBRE INTAKE REDUCES OVERALL MORTALITY - A higher intake of whole grains is associated with reduced overall mortality and in particular cardiovascular mortality.
See full article in JAMA Internal Medicine (Journal American Medical Association).
- YOUNG WOMEN WITH HEALTHY HABITS DECREASE CHANCE OF CORONARY DISEASE WHEN THEY AGE - After a research program which included 74 000 women, it clearly demonstrates that women who follow six healthy habits including eating a healthy diet, not smoking, moderate consumption of alcohol, engaging in physical activity for at least 2.5 hours a week and watch no more than 7 hours of television a week, reduced their risk of disease by a massive 92% .
See more detail on Journal American College of Cardiology JACC
- WOMEN WITH BENIGN BREAST LUMPS AT RISK OF BREAST CANCER LATER IN LIFE - Women diagnosed with Atypical Hyperplasia, a type of benign breast lump have now been found to have an ‘absolute’ risk of nearly 30% for contracting breast cancer after 25 years.
See more in special report on NEJM New England Journal of Medicine.
Jun 2014 (birth risk factors)
- First trimester of pregnancy and antidepressant use not associated with cardiac defects - (see original study on NEJM website) also see PDF containing complete research (11 page PDF 539KB).
Summary by Dr Deborah Cowley (Assoc. editor for NEJM Journal Watch Psychiatry)
"No increased risk was found between first-trimester use of antidepressants and cardiac abnormalities in an analysis published in the New England Journal of Medicine.
This very large study, which adjusted for important confounders, is reassuring in suggesting a lack of association between first-trimester antidepressant exposure and risk for cardiac defects." See full summary here.
- Older fatherhood risk - See study (following blue text is a link to the PDF) showing older fathers (over 45yo when child is born) have children with worse psychiatric and educational outcomes than younger fathers (specifically compared to fathers aged 20 - 24 when child is born).
Older fathers have children who are at higher risk of ADHD, autism, bipolar disorder, psychosis and other conditions, see PDF with commentary and abstract.
- Female contraception - New method of contraception for women study - At last, promise of a 1/3 lower hormone dose intrauterine contraceptive device (IUD) for women as an alternative to "The Pill". This research study shows the effectiveness of this new type of IUD contraception is 99.8%.It is especially beneficial for women who have never had a baby as the smaller size of this IUD can be inserted through the cervix more easily.
- Autism screening - 1 research report and 1 copy of the autism screening document
- Screening for autism in toddlers using (M-CHAT-R/F) is validated.
- What is the Modified Checklist for Autism in Toddlers, Revised with Follow-Up? or (M-CHAT-R/F)
Note the linked copy of the (M-CHAT-R/F) is not for commercial use or reuse for which permission must be gained from the copyright holders.
- High protein diet vs low protein diet - 3 studies evaluate risk
Feb 2014 (nuts - allergy treatment, consumption)
- A very early, small but brave, and well done study gives hope that the common and frightening peanut allergy will be overcome in the future. You must NOT try this at home. It could be fatal
- Unfortunately for the nut allergy sufferers (above) Research study says regular nut consumption is tied to reduced mortality risk
- Statins and cognition: a systematic review and meta-analysis of short- and long-term cognitive effects
- New treatment for Dementia using statins
- Measles in Indonesia
- Three Metabolic Risk Factors (high blood pressure, lipids, and glucose levels) could account for half of coronary heart disease risk in overweight patients
- Apparent Vitamin D deficiencies in African Americans: Protein variant at fault?
- HPV based cervical cancer screening outperforms other screening tests
- Comparing 2 new treatments for atrial fibrillation
- New drugs to treat alcohol dependance (alcoholism)
- Treatment for rheumatoid arthritis
- Metoclopramide is safe to use in Pregnancy