Clinical Corner
Aug 23, 2023

What Clinical Trials Will Shape the Future of Medicine in 2023?  

What Clinical Trials Will Shape the Future of Medicine in 2023?  

Nature medicine recently published a review of clinical trials that will shape medicine in 2023. They interviewed 11 leading experts for their top clinical research projects to watch in the coming year. Among them, a dietary intervention was highlighted. Keep reading to learn more about these trials and the relevance of nutrition research for the future of medicine.

Top 11 trials to watch in 2023

  • Parkinson’s disease: Neuroprotective effect of exenatide, used to treat type 2 diabetes, over a 2-year follow-up period.
  • Obesity and metabolic syndrome: Long-term effect of a weight-loss intervention based on a reduced-calorie Mediterranean diet, physical activity and behavioural support.
  • Alzheimer’s disease: Monoclonal antibody to amyloid-β, for the treatment of mild cognitive impairment with Alzheimer’s disease.
  • COVID-19: Efficacy of vaccines against COVID-19 in people with HIV.
  • Recurrent platinum-resistant ovarian cancer: ADC that targets tumors with high expression of folate receptor-α.  
  • Stage 2 T. brucei rhodesiense infection: Efficacy of the oral drug fexinidazole for rhodesiense sleeping sickness versus that of the existing drugs melarsoprol and suramine.  
  • Sickle-cell disease: Autologous CRISPR–Cas9-modified CD34+ human hematopoietic stem and progenitor cells.  
  • Muscular dystrophy: Base editing to repair a mutation in muscle stem cells, to rebuild muscle.  
  • Metastatic breast cancer: dissociation of CTC clusters.  
  • Prostate cancer: A new screening approach that reduces harm from PSA screening while maintaining mortality reduction.
  • Cervical cancer: HPV testing versus Pap smears to detect early-stage cervical cancer.

(Source: Nature medicine)

Nutrition research highlighted

Interestingly, there was one nutrition intervention among the list: The Mediterranean diet for weight loss. A group of researchers led by Jordi Salas Salvadó hypothesized that an intensive lifestyle-intervention program aimed at weight loss and based on the traditional Mediterranean diet is a sustainable long-term approach for achieving weight loss in overweight and obese adults, and that the lifestyle changes achieved will have a beneficial effect on cardiovascular morbidity and mortality.

The relationship between food, nutrition and health, is complex, dynamic, and multi-faceted. It is affected by biological, environmental, socioeconomic, cultural and behavioural factors. Global population growth, ageing population, impact of climate change, poor access to healthy foods, unhealthy lifestyles, and growing consumer demand, all present an increasing challenge. The global burden of malnutrition remains unacceptably high.  

At Atlantia, we strive to improve human health and wellbeing through nutrition research. From the onset of our development, we have had this shared mission. The work we do in driving scientific research further makes an enormous contribution to society. We enable scientific research by investigating and exploring how different ingredients are contributing to human health. Learn more about us.

Obesity pandemic  

Malnutrition in all its forms refers to undernutrition (i.e. classified by wasting, stunting, underweight), inadequate vitamins or minerals, overweight, obesity, and resulting diet-related noncommunicable diseases (NCD) such as diabetes, CVD and certain cancers [WHO].

Globally, 1.9 billion adults are overweight or obese while 462 million are underweight; 5 million children under 5 years of age are wasted, 155 million are stunted, while 41 million are overweight or obese. Around 45% of deaths among children under 5 years of age are linked to undernutrition; these mostly occur in low- and middle-income countries [WHO factsheet on Malnutrition, 2018].  

Both developed and emerging economies are facing the problem of rising levels of obesity and diet related NCDs. Proper nutrition offers one of the most effective and least costly ways to decrease the burden NCDs and their associated risk factors. High quality, multidisciplinary food and nutrition research and effective collaborations are key to improving global health.

The WHO defines overweight and obesity as abnormal or excessive fat accumulation that may impair health. Worldwide obesity has nearly tripled since 1975. This preventable disease represents the fifth leading risk for global deaths. At least 2.8 million adults die each year as a result of being overweight or obese.

The main strategies defined by the WHO are aligned with following a healthy lifestyle:

  • limit energy intake from total fats and sugars;
  • increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts; and
  • engage in regular physical activity (60 minutes a day for children and 150 minutes spread through the week for adults).

It is thought that been overweight is a risk factor for many other diseases such as:

  • cardiovascular disease, mainly heart disease and stroke;
  • diabetes;
  • musculoskeletal disorders, especially osteoarthritis – a highly disabling degenerative disease of the joints;
  • some cancers, including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney, and colon.

Assessing obesity

Multiple indicators tend to be used to assess obesity. Body mass index (BMI) is an index of weight-for-height that is commonly used to classify overweight and obesity in adults. However, this indicator has been recently criticised among the nutrition research field due to its inaccuracy. Many researchers state that it does not take into account muscle mass, bone density, overall body composition, and racial and sex differences.

At Atlantia, we combine both objective and subjective assessments to study weight management. We have considerable experience in conducting human clinical intervention studies to investigate weight management and nutrition conditions as 18% of trials we have conducted are categorised on this health area. Some of the most common conditions researched are: Glycaemic Control, Weight-Loss, Change in Urolithin A glucuronide plasma levels, body composition, glucose & lipid homeostasis in overweight individuals, efficacy/ absorption or DNA Methylation in human adipose tissue.

We have carried out trials on various dietary components (e.g. proteins: whey, casein, micellar forms of protein; iron) for a range of health applications (e.g. sarcopenia in the elderly, sports nutrition). Discover the range of product areas and health areas in which we have conducted trials.

Our extensive database of volunteers including overweight, athletes, healthy and elderly. Our expert research team works with sponsor(s) to design and conduct a study most suitable for their investigational product(s), agreeing and applying the most suitable measurements and statistically powering studies to ensure that study objectives are achieved and reported. Learn more about our clinical trial services.

References:
https://www.medicalnewstoday.com/articles/265215

https://www.nature.com/articles/s41591-022-02132-3

https://easo.org/media-portal/statistics/#:~:text=Overweight%20and%20obesity%20are%20the,of%20being%20overweight%20or%20obese.

https://www.who.int/news-room/fact-sheets/detail/malnutrition;  

https://mrc.ukri.org/documents/pdf/review-of-nutrition-and-human-health/