Nutrition Physician?

[Algophiliac]

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Haha, sorry for the odd thread title! A recent thread got me thinking...are any MDs directly involved in nutrition? Now, I don't mean the eat-whole-foods-drink-your-milk type of nutrition that RDs get to tout to the general public. Nor do I really want to spend time coaching obese people to just goddamn STOP gorging, lol. I mean real nutrition...research on how certain compounds and artificial ingredients affect the body, what macronutrients are used where and in what quantities and how...things like that.

The reason I ask is because I find nutrition fascinating--there's just too much we don't know about what we're putting into our bodies--who wouldn't be curious and interested about it? More specifically, I'm interested in doing research and/or somehow dealing directly with how nutrition affects the brain and/or entire nervous system. Any ideas?

 

[armybound]

you want to do research on nutrition for a living? is that what you're saying?

a lot of MDs deal with TPN and other nutrition issues on a regular. even one of our moderators does a lot with nutrition and neonates on an international level.

 

[Catalystik]

A GI doc aka Gastroenterologist (subspecialty of internal medicine) would be the expert on nutrient absorption. A Neurologist would be the expert on brain and nervous system problems and related causes.

 

[Algophiliac]

you want to do research on nutrition for a living? is that what you're saying?

a lot of MDs deal with TPN and other nutrition issues on a regular. even one of our moderators does a lot with nutrition and neonates on an international level.

No, I don't really want to do research on nutrition for a living. However, I would like it to be a part of my role as a physician to take interest in nutrition and potentially do some research (hopefully only clinical) in the field. I firmly believe in diet alterations (beyond just the obvious ones) improving health and prolonging life, and would like to somehow contribute in providing scientific proof of my beliefs to patients.

That actually sounds interesting--can anyone who deals with these issues chime in? Thanks.

 

[oldbearprofessor]

I mean real nutrition...research on how certain compounds and artificial ingredients affect the body, what macronutrients are used where and in what quantities and how...things like that.

Why yes, there are many physicians who do nutrient based research looking at a range of factors affecting diet and genetics, metabolism, etc. Physicians who do this type of research can actually be found across a large range of specialties. In pediatrics, they are often found in neonatology, endocrinology and GI, hepatology and nutrition (that's one field). I know surgeons who do this type of research and of course in adult medicine there are cardiologists, endocrinologists and GI docs among others.

There is even a board specialty in medical nutrition, although it is not widely taken and not needed for research. So, sure, it's possible, although I would point out that doing human metabolism studies is not easy and is almost impossible without the collaboration of research dietitians.😉

 

[LizzyM]

Research is a team sport and it is likely that you would work with research dietitians, psychologists, neurophysiologists, etc to do clinical research on the effect of nutrition on brain function.

I don't know of anyone doing work in that area specifically although I have some familiarity with the effects of micronutrients (e.g. copper, iron, zinc) on athletic perfomance in elite athletes. Some of that work has been done by physiologists (PhD) not MDs and it is a very small niche (not many doing work in that area).

 

[Gingersnap205]

During my undergrad, I worked at a nutrition research center at Tufts. They had numerous studies ongoing dealing with different nutrients and their effects on the body. For example, there was a study looking at a Hispanic diet versus an American diet and its effect on blood pressure. Another dealing with Vitamin D. So it definitely is possible. I don't know if the doctors were boarded nutrition specialists though.

 

[LizzyM]

During my undergrad, I worked at a nutrition research center at Tufts. They had numerous studies ongoing dealing with different nutrients and their effects on the body. For example, there was a study looking at a Hispanic diet versus an American diet and its effect on blood pressure. Another dealing with Vitamin D. So it definitely is possible. I don't know if the doctors were boarded nutrition specialists though.

Much of that work is done by epidemiologists (PhD or MD/PhD or MD/MPH or MD/MS) who specialize in cardiovascualar disease (blood pressure) and nutrition/lifestyle. That's a little different than the effect of specific nutrients.

There are those who put reseach subjects in a controlled setting for weeks at a time to study specific nutrients. Then there are those who study free living people in their "natural habitats" so to speak to look at dietary intake (or the effect of educating and counseling people about changing their diet) on health.

 

[myhandsarecold]

I'm personally interested in GI or Bariatric surgery but there is one "subspecialty" that deals with nutrition, check out this "Dr. Melina Jampolis, a physician nutrition specialist" from CNN:

http://www.drmelina.com/About_Us.html

 

[Algophiliac]

Research is a team sport and it is likely that you would work with research dietitians, psychologists, neurophysiologists, etc to do clinical research on the effect of nutrition on brain function.

I don't know of anyone doing work in that area specifically although I have some familiarity with the effects of micronutrients (e.g. copper, iron, zinc) on athletic perfomance in elite athletes. Some of that work has been done by physiologists (PhD) not MDs and it is a very small niche (not many doing work in that area).

Thanks, LizzyM and everyone!!

I have an interesting question concerning how to break into such clinical research opportunities. When I read books or magazines featuring diet programs, the names of physicians are constantly mentioned--for example, in the case of the Dean Ornish diet program or the Atkins diet programs.

To my knowledge, the Dean Ornish diet program was created to combat heart disease and lower cholesterol, a nutritional take on healing, which is exactly what I am interested in promoting, although more specifically in the brain--research to create diets or determine certain bodily effects (both harmful or beneficial) toward illnesses as a result of diets.

What I find most interesting, however, is that most MD names referenced in diet magazines are those of associate professors (at Duke or Yale or some such high-up institutions only, actually 🙁). Do non-academic physicians or surgeons, including those in less prestigious or well-known institutions, have any chance of breaking into this nutrition field? Also, to what specialties do most of these referenced physicians or surgeons belong?

Thanks everyone!! Also, would it maybe help to have an undergrad major in nutrition? I hear from sdn that it is looked down upon if you get an undergrad major in nursing or nutrition, and then go on to do medical school? I would also prefer to just get a neuroscience (or some similar) major instead...would this hamper me in trying to attain a future career in nutritional sciences as an MD?

 

[LizzyM]

I think that there are a few different things going on with physicians who provide nutrition information:

first is evidence. What is the basis for the recommendations being made by the expert? Dean Ornish can point to the Lifestyle Heart Trial, a clinical trial conducted in ~1980s. To do such a trial, one generally needs the infrastructure of a major medical center/medical school as well as federal grant funding. That type of work is centered at the top research med schools (which is why they are ranked at the top -- they get the funding and the reputations and spiral upward). Having scientific evidence creates an aura of credibility which while not essential is helpful (the charlatans seem to do fine without any hard evidence).

second is prestige. A physician who wants to gain national attention is going to have an easier time of it if connected to a "name brand" medical school or a practice among celebrities or the very rich. Certain schools have more cachet than others in the minds of the public and a doctor from one of those schools (Harvard, Duke, as mentioned) is going to get more attention because of the prestige.

third is exposure Are you going to be booked on the Today show if you are an assistant professor at ___ medical school in NY or n doc from Queens who has some intersting ideas? (How is anyone going to know you have those good ideas? Who is going to help you get a book deal? Who is going to promote you as an expert?) Research intensive medical schools employ public relations specialists whose jobs are to publicize research projects at the medical school and provide faculty members to serve as "experts" when TV, radio, magazines & newspapers are looking for panelists, or commentary on a news topic.

However, as interesting as I've found this to think about, we are putting the cart before the horse. What's going to get you up in the morning for the next 10 years as you jump through the hoops you'll need to jump through to get a shot at promoting nutrition for better cognitive health? Is this your mission? Even if it doesn't bring fame & fortune? Do you understand what I'm getting at?

 

[Algophiliac]

I think that there are a few different things going on with physicians who provide nutrition information:

first is evidence. What is the basis for the recommendations being made by the expert? Dean Ornish can point to the Lifestyle Heart Trial, a clinical trial conducted in ~1980s. To do such a trial, one generally needs the infrastructure of a major medical center/medical school as well as federal grant funding. That type of work is centered at the top research med schools (which is why they are ranked at the top -- they get the funding and the reputations and spiral upward). Having scientific evidence creates an aura of credibility which while not essential is helpful (the charlatans seem to do fine without any hard evidence).

second is prestige. A physician who wants to gain national attention is going to have an easier time of it if connected to a "name brand" medical school or a practice among celebrities or the very rich. Certain schools have more cachet than others in the minds of the public and a doctor from one of those schools (Harvard, Duke, as mentioned) is going to get more attention because of the prestige.

third is exposure Are you going to be booked on the Today show if you are an assistant professor at ___ medical school in NY or n doc from Queens who has some intersting ideas? (How is anyone going to know you have those good ideas? Who is going to help you get a book deal? Who is going to promote you as an expert?) Research intensive medical schools employ public relations specialists whose jobs are to publicize research projects at the medical school and provide faculty members to serve as "experts" when TV, radio, magazines & newspapers are looking for panelists, or commentary on a news topic.

However, as interesting as I've found this to think about, we are putting the cart before the horse. What's going to get you up in the morning for the next 10 years as you jump through the hoops you'll need to jump through to get a shot at promoting nutrition for better cognitive health? Is this your mission? Even if it doesn't bring fame & fortune? Do you understand what I'm getting at?

Wow, thank you for that analysis. Fortunately I'm not really interested in becoming the next Dean Ornish, but rather in just doing some of the clinical research involved in making certain nutrition claims. I have no intention of ever ending up in a magazine--I just want to take part in researching the information to get it out there! 😛

The reason I mentioned magazines and books and such is because I was honestly surprised to find that most diet advice was given out by MDs, instead of by PhDs or RDs, who I for some reason previously assumed did most of the research involved in nutrition studies. Huh. I must have been wrong.

Also, I want to make it clear that I don't want to promote nutrition (as a whole) as a goal in itself. But I do feel as though, in addition to a stable practice as a neurologist (or whichever specialty, if I'm lucky, I get to choose), side clinical research in how nutrition affects the brain would be exciting.

There are so many claims and research events going on around serotonin levels relating to depression, the effects of Lorenzo's Oil on ALD, and etc, that I feel as though analyzing nutrition statistics would be beneficial to the field. I suppose I am really stretching what I mean by "nutrition"?

 

[LizzyM]

The reason I mentioned magazines and books and such is because I was honestly surprised to find that most diet advice was given out by MDs, instead of by PhDs or RDs, who I for some reason previously assumed did most of the research involved in nutrition studies. Huh. I must have been wrong.

Go back.... this is a team sport. There are PhDs, RDs and MDs (and combinations of those credentials) involved in clinical research on nutrition. However, when push comes to shove the "MD" Doctor is usually considered more authoritative and therefore has more prestige with the media and is going to be the person asked to comment for the news story.

Brain, behavior and cognitive function is a new frontier and there is a lot to learn. Physicians are almost always involved in clinical trials of new treatments, even new diet treatments, to assure that the subjects remain safe. Dietitians tend to be tasked with converting nutrient requirements into diet plans or menus and supervising the preparation of meals or foods if those are provided to the participants as part of the research study. Dietitians or nurses usually provide the teaching/training/counseling required to inform subjects of the diet plan and provide ongoing education & support. Dietitians are generally most skilled at collecting and making sense of data about dietary intake (measuring what people ate or say that they ate) and knowing the data bases available to provide information about the nutrient values of foods. Physicians and neurophysiologists may collaborate in diagnostic imaging studies looking at brain function (such as fMRI). Clinical psychologists do the neuropsychological testing that measures baseline function and assesses changes over time.

The gold standard in clinical medicine is the double-blind, randomized, controlled clinical trials. They aren't easy and they take a team and the dedication to devote a half-day or more per week to work on the trial, often at a salary far lower than you could earn if you spent that time providing patient care. You need to decide if that is worth it to you. It is fraught with difficulty and takes a long, long time and may, in the end, show results that are not going to be useful in moving the field forward.

 

[Algophiliac]

Go back.... this is a team sport. There are PhDs, RDs and MDs (and combinations of those credentials) involved in clinical research on nutrition. However, when push comes to shove the "MD" Doctor is usually considered more authoritative and therefore has more prestige with the media and is going to be the person asked to comment for the news story.

Brain, behavior and cognitive function is a new frontier and there is a lot to learn. Physicians are almost always involved in clinical trials of new treatments, even new diet treatments, to assure that the subjects remain safe. Dietitians tend to be tasked with converting nutrient requirements into diet plans or menus and supervising the preparation of meals or foods if those are provided to the participants as part of the research study. Dietitians or nurses usually provide the teaching/training/counseling required to inform subjects of the diet plan and provide ongoing education & support. Dietitians are generally most skilled at collecting and making sense of data about dietary intake (measuring what people ate or say that they ate) and knowing the data bases available to provide information about the nutrient values of foods. Physicians and neurophysiologists may collaborate in diagnostic imaging studies looking at brain function (such as fMRI). Clinical psychologists do the neuropsychological testing that measures baseline function and assesses changes over time.

Wow, great summary! Both the tasks of the physicians and neurophysiologists and clinical psychologists sound exciting. I guess I never considered that the prestige factor would let only the MDs get any media attention, completely ignoring the fact that PhDs and RDs collaborated on the projects as well! 🙁 That's just not fair at all, in my opinion.

The gold standard in clinical medicine is the double-blind, randomized, controlled clinical trials. They aren't easy and they take a team and the dedication to devote a half-day or more per week to work on the trial, often at a salary far lower than you could earn if you spent that time providing patient care. You need to decide if that is worth it to you. It is fraught with difficulty and takes a long, long time and may, in the end, show results that are not going to be useful in moving the field forward.

Would you say this also applies to all research, not just nutrition research from a cognitive take? And by extension, would this not also apply to an academic doctor, as well? I hear they get paid less, because they spend a majority of time doing research, which pays less than doing actual patient care clinic duties.

What bothers me most about that, though, is that I'd get to see fewer patients if I had to devote all of my time to research alone. 🙁

 

[LizzyM]

Wow, great summary! Both the tasks of the physicians and neurophysiologists and clinical psychologists sound exciting. I guess I never considered that the prestige factor would let only the MDs get any media attention, completely ignoring the fact that PhDs and RDs collaborated on the projects as well! 🙁 That's just not fair at all, in my opinion.

The physician is the leader of the team. Talking to the press is what the leader does. No one interviews the fighter pilot, they interview the general.

Would you say this also applies to all research, not just nutrition research from a cognitive take? And by extension, would this not also apply to an academic doctor, as well? I hear they get paid less, because they spend a majority of time doing research, which pays less than doing actual patient care clinic duties.

What bothers me most about that, though, is that I'd get to see fewer patients if I had to devote all of my time to research alone. 🙁

Yes, it applies to all research. It applies to some academic doctors. Many academic physicians do little or no research but contribute to the academic enterprise through administration (managing personnel, budgets and policies for their division or department or through the Deans office), clinical care (that brings in the money that supports the medical school) and teaching of clinical skills and clinical decision making as well as the supervision of trainees in clinical settings (that is also considered "teaching" and is sometimes called "being on service").

 

[Narmerguy]

Would you say this also applies to all research, not just nutrition research from a cognitive take? And by extension, would this not also apply to an academic doctor, as well? I hear they get paid less, because they spend a majority of time doing research, which pays less than doing actual patient care clinic duties.

What bothers me most about that, though, is that I'd get to see fewer patients if I had to devote all of my time to research alone. 🙁

Eh, you seem to be trying to have it all. Throughout the thread what you are looking for seems highly specific and you have to take the good with the bad. You don't have to devote all your time to research alone but if you want your research to be effective and thorough, you'll have to devote a good portion of your time to it. Many academic physicians are required to maintain certain levels of research to patient care ratios (or close to it). For example, 60-40 or 70-30. Some people may do 80-20 (with either research or clinical care being the dominant one). I think a lot of this depends on where you work and whom you work for. Some people have different expectations of their physicians.