The U.S. Department of Agriculture’s Agricultural Research Service (USDA ARS) established the W.O. Atwater Memorial Lecture in 1968 to honor the memory of Wilbur Olin Atwater (1844-1907) and to recognize scientists who have made unique contributions toward improving the diet and nutrition of people around the world. Atwater, considered the father of modern nutrition research and education, was the U.S. Department of Agriculture’s first chief of nutrition investigations.
ARS is pleased to partner with the American Society for Nutrition in presenting the 2019 Atwater Memo-rial Lecturer, Dr. George A. Bray. Dr. Bray is a Boyd Professor Emeritus at the Pennington Biomedical Research Center at Louisiana State University. He is a leader and pioneer in the field of obesity research. His leadership, expertise, and dedication to under-standing the causes and biology of human obesity have informed public health policy and positively affected the quality of life for millions of people.
Bray: I am delighted and honored to be selected as this year’s W.O. Atwater Lecturer and to walk in the footsteps of the distinguished scientists who have preceded me. Dr. Atwater has been one of my heroes, and over the years I have collected many of his works. I am grateful to have been nominated for this award.
ARS: What inspired you to pursue a career in obesity research?
Bray: My mentor, Professor Edwin Astwood—one of the leading endocrinologists at the time—gave his presidential address to the Endocrine Society while I was a postdoctoral fellow in his lab. In his address, the “Heritage of Corpulence,” Astwood stated:
Obesity is a disorder which, like venereal disease, is blamed upon the patient. The finding that treatment doesn’t work is ascribed to lack of fortitude . . . I wish to propose that obesity is an inherited disorder due to a genetically determined defect in an enzyme; in other words, that people who are fat are born fat, and nothing much can be done about it.
Around that same time, Professor Astwood came into the laboratory and described a group of fat lab rats that he had recently received. I submitted an NIH grant proposal to study obesity in these rats. NIH funded the proposal, and I haven’t left the field since!
ARS: Looking back on your career, did anything surprise you in your research?
Bray: I have been surprised at the difficulty of finding effective treatments for obesity. I have also been surprised that no effective strategies have been developed to enhance energy expenditure as a mechanism for weight loss. The body is pretty good at getting and storing energy and protein plays a pivotal role. If you overfeed someone on a very low protein diet, they won’t gain as much weight as someone overfed on a normal or high protein diet. Protein contributes to the changes in energy expenditure and increases in lean body mass, along with body fat. Calories are the main contributor to increases in body fat, but protein modifies the distribution of these calories.
ARS: Have you personally ever struggled with obesity?
Bray: I have never been obese except for an experiment. Before my first overfeeding study when we asked normal weight people to gain weight, I thought I should go through the experience first. So I decided to fatten myself up. I gained 31 pounds over the course of three months. I felt pretty awful during the process –I had only one pair of pants I could wear, I couldn’t even button the neck of my shirt, and I was hot all of the time. After the experiment, it took me no time to lose it all. I slid back down to 165 pounds. That was 55 years ago, and I weigh the same now.
ARS: What aspects of your work make you most proud?
Bray: The DASH (Dietary Approaches to Stop Hypertension) trial stands out to me as the most important part of my work. It had a major public health impact and remains at the forefront of selected diets for over-all health quality. The DASH diet is one of the most widely accepted diets for improving blood pressure and, if used in a lower calorie version, it produces weight loss. The DASH diet has been translated to YMCA pro-grams across the country and many other diets. A second major study, the POUNDS (Preventing Overweight Using Novel Dietary Strategies) Lost trial, showed that high- and low-fat diets and average- and high-protein diets produced equivalent amounts of weight. It was calories, not macronutrients, that made the difference in weight gain. The conclusions from this trial were incorporated into the Guidelines for Management of Over-weight and Obesity in adults from the American College of Cardiology/American Heart Association Obesity Society. The trial has since provided data to allow selection of diets based on some genetic markers. In two other trials, the Diabetes Prevention Program and Look AHEAD (Action for Health in Diabetes) trial, we showed that the development of diabetes can be delayed or prevented with lifestyle and weight loss, and that this same nutritional and lifestyle strategy can positively impact the health of people who already have diabetes.
ARS: What have been some of the most challenging aspects of your work?
Bray: Funding! I spent lots of time and effort in writing grants.
ARS: And that was more challenging than making yourself obese?
Bray: Yes! But USDA was very good to us. My projects at Pennington on adaptation to dietary fat were all funded by USDA grant support. So was our overfeeding study on different levels of dietary protein. I’m very grateful for that research support.
ARS: You have had numerous television appearances throughout your career in which you have communicated about your obesity research. How did you get these opportunities?
Bray: For TV interviews, you either need to have the right kind of face and smile or be the only person working in your field. At the time that I entered the field, there were only four of us nationwide with any sort of visibility in the obesity field. In the 1970s and ‘80s, I founded the International Journal of Obesity, served as the editor for the North American Association for the Study of Obesity, and chaired organizing committees for the Fogarty Center’s conferences on diabetes and obesity.
ARS: To what do you attribute your successes?
Bray: Being in the right place at the right time and having good mentors. I had the opportunity to work with Astwood at Tufts around the time that he delivered his “Heritage of Corpulence” address to the Endocrine Society. When I was selected to direct Pennington, I made a major career switch from largely animal research to predominantly clinical work. Pennington had lots of sup-port, especially from USDA. They provided the tools and we were able to make significant advances using them.
ARS: What challenges do you see ahead for the field of nutrition research?
Bray: The obesity epidemic remains a major challenge. It hasn’t stopped yet, and even if it does now, there are too many people whose health is negatively impacted by obesity. Our genes load the gun, but the environment pulls the trigger that makes many of us fatten up. Obesity requires excess calories, these calories come from food, but food is much more than calories. Sorting out the way in which nutrition can be used to reduce the impact of obesity is a major future challenge. This will certainly require a change in our nutritional environment. Our current food environment is going to keep on promoting obesity.
ARS: What advice would you provide to other nutrition researchers getting started off in their careers?
Bray: Make sure you’re passionate about it. Whatever you do, do it with passion. Make sure it makes your eyes light up. Don’t do it because you think you ought to. To learn more about the DASH trials, POUNDS Lost trial, Diabetes Prevention Program, Look AHEAD trial, and other of Bray’s “Lessons Learned in the Tradition of Atwater,” be sure to attend the 2019 Atwater Memorial at 3 PM on Sunday, June 9, in Ballroom I/II at Nutrition 2019. All are invited to attend the reception following the lecture.