May 3, 2004

Straus: Alternative therapies undergo conventional research   

By Eric Rangus

Complementary and alternative medicines—fad diets, herbal remedies, and the like—are a multibillion-dollar industry. They are such a large part of the modern health care conversation that the National Institutes of Health created a center focused on their study, and that center’s director delivered the latest installment of the Future Makers Lecture Series, Wednesday, April 28, in the Emory Hospital Auditorium.

Stephen Straus, director of the National Center for Complementary and Alternative Medicine (NCCAM), delivered the lecture, “Complementary and Alternative Medicine: From Promises to Proof,” and it was an in-depth, 45-minute presentation that defined alternative therapies, gave their history and outlined the manner in which NCCAM is studying them.

The center was established in 1998 and funded in 1999, the year Straus was hired. An internationally recognized expert in clinical research and clinical trials, Straus also is senor investigator in the Laboratory of Clinical Investigation at the National Institute of Allergy and Infectious Diseases (NIAID).

“The center provided an opportunity so few of us have,” said Straus, who has published more than 375 articles and edited several books. “To build a new scientific discipline.”

Straus grouped complementary and alternative medicines into five categories: biologically based (diets and herbals), body-based (chiropractic and massage), mind-body (yoga, prayer and meditation), alternative medicine systems (homeopathy and naturopathy) and energy therapy (magnets, reiki).

He outlined the history of alternative medicines, which included a PowerPoint slide displaying carnival-like advertisements for elixirs guaranteeing health for their users. Straus mentioned how alternative therapies have moved into the mainstream (the wildly popular Atkins and South Beach diets, for instance, are alternative therapies that have, as Straus pointed out with statistics, some validity).

Straus then discussed some dangers involved with relying on alternative rather than scientifically proven therapies. “You need to be sure you are taking what is proven to work before you start taking things you wish to work,” he said.

The second half of Straus’ presentation covered the ways NCCAM is researching the marketplace’s many alternative medicines. It’s not always easy, and many built-in hurdles exist. “We can’t ask people to withhold therapies that are medically proven,” Straus said. “We can’t ask them to undergo arcane procedures. Can drinking coffee prevent diabetes? There are a lot of things we’ll never know.”

Much useful research is possible, though. NCCAM currently is researching a variety of dietary supplements; another investigation is looking into whether cranberries have an effect on urinary-tract infections in women (a common tale handed down through generations.) One study, Straus said, debunked a theory that magnets had an effect on heel pain.

Herbal remedies, one of the most popular complementary and alternative medicines, are frequent study subjects. One current investigation is looking into whether the Ginkgo biloba can decrease incidence of dementia, including Alzheimer’s disease, in older adults. “There are only two possibilities,” Straus said. “If it is negative, we will have learned a great deal about how to do prevention studies for Alzheimer’s.
If it is positive, then there is something remarkable.”

The School of Medicine is no stranger to complementary and alternative medicine. The Emory Center for Research on Complementary and Alternative Medicine in Neurodegenerative Diseases was founded in 2001.

Its director, Mahlon DeLong, professor of neurology, was among the more than 100 in attendance.

The Emory center has funded more than $385,000 worth of pilot studies, including investigations of neuromuscular massage therapy on Parkinson’s patients and the use of bile acids as neuroprotective agents in neurodegenerative diseases of the retina.