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Interview with Elizabeth J. Parks

Interview with Elizabeth J. Parks, Professor at the University of Missouri and Past Chair of the ASN Publications Committee

Since 2013, Dr. Parks has been a Professor in the Department of Nutrition & Exercise Physiology and Associate Director of the Clinical Research Center in the Institute for Clinical Translational Science at the University of Missouri (fondly known as Mizzou). Previously, she was Associate Professor in Clinical Nutrition at the University of Texas Southwestern Medical Center. Recently, she received the University of Missouri School of Medicine’s 2015 Award for Excellence in Junior Faculty Research Mentoring and the 2016 Robert I. Levy Award from the Kinetics and Metabolism Society.

1. How did you first get involved in nutrition epidemiology and research? What made you interested in the field of nutrition science?

The genetics of heart disease strongly affects the health of my family, and influenced my academic path. Early in my career, I worked as a technician in a lab with cardiovascular researchers who stressed the importance of nutritional strategies in treating chronic diseases. I was impressed with how a prudent diet could improve health.

2. When and why did you first join ASN? What convinced you to join the organization?

ASN was the scientific organization that my mentor, Barbara Schneeman, was active in. Like many other graduate students, my first scientific presentation was at EB and over the past 27 years, membership has benefited my career in many ways. I learned early on that being involved in professional associations was the key to success, and that’s true for any career. These organizations provide essential networking opportunities – even simply talking to someone at a conference poster presentation can change the course of your academic or career trajectory.

3. What aspects of ASN membership have you found most useful, professionally? What other aspects of your membership do you find useful as your career has progressed?

Attending the scientific meeting has been the most rewarding. Aside from the excellent science presented there, this is the venue I attend to mentor and to be mentored. It is very rewarding to follow colleagues as their careers advance and to witness how a scientific life can have such a positive impact on others. At conferences, we have the chance to speak with people who are in a similar life stage as you, and we’re surrounded by others who understand the difficult life of a scientist. If you’re struggling to solve a problem, you have an audience of experienced researchers who can offer many possible solutions.

4. What aspects of your research do you foresee being most important for ASN members?

I study how the body’s metabolism changes when we are fasting and then eat a meal. Food consumption is the physiologic challenge that our bodies are exquisitely designed to manage. In health, right at the beginning of a meal, a complete 180 degree shift in metabolic flux occurs. The body switches from burning stored nutrients (body fat and glycogen), to absorbing, burning and storing the nutrients in the meal. Importantly, in chronic disease, this switch is not well regulated and it is this inefficiency that causes disease pathologies.

5. Can you tell us more about your current position and the research activities in which you are involved?

At Mizzou, I am fortunate to be surrounded by some of the best human physiologists in the U.S. working in state-of-the-art facilities. We have many collaborative projects that investigate the effects of over-eating and sedentary behavior on metabolism. One NIH-funded study focuses on the benefits of diet and exercise to treat nonalcoholic fatty liver disease. We hypothesize that weight loss and improved fitness, both shown to reduce liver disease, do so through a mechanism of enhanced mitochondrial activity. This project would not be possible without the collaboration of faculty in the Department of Nutrition and Exercise Physiology.

6. What do you feel are the biggest challenges facing nutrition researchers today? Are there any areas where you would like to see more research?

One of the biggest challenges facing us is that the power of the scientific approach is currently under-appreciated in our culture. Some people want to believe that a particular nutritional strategy will solve all ills. Since nutrition messages in the press have appeared to be contradictory (this week, “Coffee is good for you,” next week, “coffee is bad for you.”), this has led many in the public to just tune us out. Our discipline has the same attributes of other sciences – information is ever evolving. Thus, dietary advice may also change over the years. We need to do a better job of communicating how nutrition science leads to discoveries that can benefit individuals and improve the health of citizens.

Nutrition science is also by nature interdisciplinary, and we must cross disciplines in order to be effective. We must work in teams: animal researchers can collaborate with human researchers to make sure their results will apply to the human condition, and epidemiologists can get more mechanistic with data collection. It doesn’t make sense for any one person to attempt a novel discovery, and we will be more effective once communication across disciplines improves.

7. Is there anything else you’d like to tell ASN members, especially students and postdocs?

I have four concepts for mentees to mull over. First, bring energy to your training environment. You need energy, self-motivation and organization to flourish in an academic setting. Trainees must reach out and grab a hold of the experiences that are presented to them. If a mentor is writing a grant or review paper, ask to participate in the process. If another trainee needs assistance in acquiring data, volunteer to help them. Keep your eyes open for opportunities to assist others. Give your time to a professional organization and mentor those around you. The time spent in a doctoral program or postdoctoral fellowship will go by quickly and these environments provide once-in-a lifetime opportunities to learn.

Second, give your mentors a break. Mentees frequently do not know all the pressures and responsibilities their mentors are up against. In a research lab setting, because your mentor has built that environment, you get to learn in it; spend some time to learn what your mentor has gone through to get where they are. The worst situation to be in is when we don’t know what we don’t know – it is much better to be wrong and know why. So find out what your mentor’s job is really like: what are their current challenges, and how can you help them be successful?

Third, set goals, but enjoy your work along the way. In academics, our paths are frequently like being on a treadmill, forever going up hill. The feeling can be, ‘you have not succeeded until you’ve finished your doctoral degree.’ Then, you’ve not succeeded until you’ve completed postdoctoral experiences. Next, you aren’t a success until you get your first job. And then there’s the goal of promotion and tenure. If you wait until you have achieved a promotion to be happy, you will have been unhappy a good portion of your career. It is important to find a way to enjoy the everyday work of science…even when it means repeating that experiment a third time!

Lastly, embrace the complexity of your science. Despite the huge gains that have been made in understanding the molecular control of gene expression, much less is known about the individual responses of human physiology to nutrients and dietary patterns. Understanding the factors that contribute to individual responses will be key to future developments in precision medicine. This field is complex but it represents one avenue of nutrition science that is wide open for discovery.

Dr. Parks’ research interests include cephalic phase of food intake and sensory effects on absorption of lipids, the effect of dietary macronutrients on the development of obesity-related disorders, non-alcoholic hepatic steatosis, liver inflammation, and postprandial metabolism, and modeling of non-steady state kinetics in metabolism.

Interview with Marion Nestle

Interview with Marion Nestle, Professor of Nutrition, Food Studies, and Public Health at New York University and Advisor for the ASN Early Career Nutrition (ECN) Interest Group

Dr. Nestle is the Paulette Goddard Professor of Nutrition, Food Studies, and Public Health at New York University, where she has been since 1988. She is also a professor of Sociology at NYU and a visiting professor of Nutritional Sciences at Cornell University. Recently, she won writing and literary awards from the James Beard Foundation and the International Association of Culinary Professionals for her most recent book, Soda Politics: Taking on Big Soda (and Winning).

1. How did you first get involved in nutrition epidemiology and research? What made you interested in the field of nutrition science?

My doctorate is in molecular biology (nucleic acid enzymology) so I have longstanding experience in science. My first teaching job was in the Biology Department at Brandeis University, where I ran the undergraduate biology laboratory courses and taught molecular and cell biology to majors and premeds.
The department was unusual in having two teaching rules: you could only teach the same course three times in a row (so you stayed fresh), and you had to teach whatever the department needed (because you knew more than undergraduates). When my three years of cell biology were up and it was time for me to switch courses, it turned out that students had been petitioning the department to teach human biology courses. I was offered a choice of human physiology or human nutrition, and picked nutrition.
This was in the mid-1970s. Two-time Nobel Prize winner Linus Pauling had just published Vitamin C and the Common Cold, and Frances Moore Lappé’s Diet for a Small Planet was on the best seller list. Michael Jacobson had just launched Center for Science in the Public Interest and published Food for People, Not for Profit, a book of essays about food topics that could have been written yesterday. I picked nutrition to teach because I was curious to know whether there was any science behind any of this.
To find out, I started reading the literature. I soon discovered that there is plenty of science but that humans make terrible experimental animals. Methods are imprecise and results hard to interpret. Whereas teaching cell and molecular biology means teaching students to accept abstractions that they cannot see, taste, smell, or feel, teaching nutrition was fun—and a fabulous way to teach critical thinking in biology. In those days, any undergraduate could read a nutrition research paper and see inadequacies in methods or interpretation. It was like falling in love and I’ve never looked back.

2. When and why did you first join ASN? What convinced you to join the organization

I left Brandeis for a job teaching nutrition to medical students at UCSF, where we created a coordinated program we called Nutrition UCSF. I worked with faculty in various specialties to put that together. We had a federal grant to teach nutrition to medical students and physicians. Some of the faculty were involved in developing nutrition support teams to work with hospitalized patients. I worked with them to establish the Northern California chapter of the American Society for Parenteral and Enteral Nutrition and started going to its meetings. At one of them, I met Lyn Howard (from Albany Medical College), and she suggested I join the American Society for Clinical Nutrition and the American Institute for Nutrition, the ASN forerunners. She sponsored my applications, and I felt honored when they were accepted. This must have been in the early 1980s, but I can’t find a record of the exact year.

3. What aspects of ASN membership have you found most useful, professionally? What other aspects of your membership do you find useful as your career has progressed?

I came into the nutrition field from outside it and didn’t know who was who or what was what for a long time. I should add that toward the end of my sojourn at UCSF it was clear that I needed nutrition credentials and I did a master’s in public health nutrition at Berkeley. I did my public health field work as a consultant for the Agency for International Development in Southeast Asia, and went from there to Washington, DC as senior nutrition policy advisor to the Department of Health and Human Services, where I edited the 1988 Surgeon General’s Report on Nutrition and Health. For one regrettable reason or another, I’ve never been able to attend annual meetings regularly so my main contact with ASN has been through its journals. I mostly know ASN members through other professional routes.

4. What aspects of your research do you foresee being most important for ASN members?

The most important one has to do with conflicts of interest. I’ve been increasingly concerned about the damage to the reputation of nutrition researchers caused by financial ties to food companies with a vested interest in the outcome of their research. I was embarrassed for our profession by Michele Simon’s report: “Nutrition Scientists on the Take from Big Food: Has the American Society for Nutrition Lost All Credibility.” I spoke about my concerns at the initial meeting of ASN’s current “truth” committee and am looking forward to its forthcoming report.

5. Can you tell us more about your current position and the research activities in which you are involved?

I am answering these questions a couple of months before I officially retire from NYU after 29 years, although I don’t expect much to change in my professional life. I am keeping my office and title for a few more years, at least. My current book project is about the effects of food industry funding of nutrition research and practice. This is a long-standing concern that I’ve been writing about occasionally since 2001, including in Soda Politics. I decided to do the book after reading the New York Times’ front-page story on Coca-Cola’s funding of investigators behind the Global Energy Balance Network, whose leaders argued that physical inactivity is more important than overeating in determining body weight. This book will have a chapter about the reputational risks of ASN’s financial ties to food companies.

6. What do you feel are the biggest challenges facing nutrition researchers today? Are there any areas where you would like to see more research?
I’ve always believed that the most intellectually challenging problem in our field is determining what people actually eat. Everyone other than nutrition professionals thinks getting dietary information is easy and so is relating it to chronic disease risk. But I think formulating research questions and designing studies to answer questions about diet and health are enormously difficult and I have great respect for everyone who takes on such questions. That’s the intellectual challenge.
The more practical challenge is the need for fully independent funding. Federal funding for nutrition research is limited and the cuts threatened by the Trump Administration will only make the need more critical. Without independent funding, the nutrition research agenda gets skewed in favor of projects food companies can use for marketing. The big research questions are to define dietary patterns that promote health, find ways to provide healthful diets to people who lack resources, and identify effective dietary approaches to preventing noncommuncable diseases.

7. Is there anything else you’d like to tell ASN members, especially students and postdocs?

This is a field that badly needs well trained researchers who can tackle the complex biological, social, and political issues related to food and nutrition on the research agenda. These are tough issues to address and they need all the help they can get. I’m planning to end my book about food industry funding with advice to stakeholders. My advice to students and postdocs is to be careful about accepting research funding from any company that has even the remotest interest in the outcome of their studies. The evidence that industry funding influences research outcome is overwhelming and undeniable. Furthermore, recipients are unconscious of the influence, making protection difficult. If at all possible, find another source of funding. If your research supervisor insists that you accept industry funding, consider working with another research supervisor. Credibility and integrity matter a lot at every career stage. You might as well start yours out right.

Dr. Nestle’s research and writing examine scientific and socioeconomic influences on food choice, obesity, and food safety, emphasizing the role of food marketing. Her interests in nutrition and food policy and politics include food and nutrition policy development and analysis (domestic and international), with a focus on dietary guidance, social and environmental influences on food choice, and the effects of food industry marketing on diet and health; and communicating information about the links among agriculture, food, nutrition, and health to students, professionals, and the public. Since 2002, she has written eight books on such topics. Her next book, tentatively titled “Buying Nutrition Science: How Food Industry Sponsorship Skews Research and Harms Public Health,” will be published by Basic Books late in 2018.

Interview with Laura Murray-Kolb

May 2017 Member Highlight Interview for ASN Nutrition Notes eNewsletter:

Interview with Laura E Murray-Kolb, Professor at Pennsylvania State University and Chair of the ASN Membership Committee

Dr. Murray Kolb is Associate Professor and Professor-in-Charge of the Graduate Program of the Department of Nutritional Sciences in the College of Health and Human Development at Penn State University, where she has been since 2010. Previously, she was Assistant Professor in the Department of International Health, Program in Human Nutrition at Johns Hopkins Bloomberg School of Public Health where she continues to hold an adjunct faculty position. Recently, she was the 2016 recipient of the American Society for Nutrition’s Norman Kretchmer Memorial Award in Nutrition and Development, given to a young investigator for a substantial body of independent research in the field of nutrition and development with potential relevance to improving child health. Dr. Murray-Kolb was honored for her innovative studies on the influence of iron deficiency on mother/child interactions and subsequent child development.

1. How did you first get involved in nutrition research? What made you interested in the field of nutrition science?

Ever since high school, I was interested in finding ways to improve health with good nutrition, to enhance athletic performance, to show how eating nutritious foods could lead to better health. My goal was to become a surgeon, and I took a couple of nutrition courses. I delayed medical school and got my Master’s Degree in nutrition, as I felt it was important to have a strong foundation in nutrition in order to become a good doctor. During my early years in graduate school, I became passionate about nutrition research, thanks to the mentorship of John Beard. His enthusiasm for research was almost contagious! I went on to get my PhD in Nutrition as I wanted to pursue a career where I had the opportunity to explore questions not yet answered, and to work with brilliant scientists who are also looking for those answers. I have the good fortune to be active in the field, looking for ways to improve health with good nutrition, especially for mothers and children.

2. When and why did you first join ASN? What convinced you to join the organization?

Like many members I joined ASN as a student, getting ready to present my abstract at the 2004 ASN meeting at EB. My mentor encouraged me to join and to become active in ASN. At EB, I became exposed to the wonderful science I now get to practice. I felt (and still feel) proud to be a part of the premier global organization in nutrition science, to be witness to the latest scientific findings, and to help influence nutrition policy worldwide.

3. What aspects of ASN membership have you found most useful, professionally? What other aspects of your membership do you find useful as your career has progressed?

Having access to the leading journals in the field is a key membership benefit for me. Penn State also has access to ASN journals, but my personal access has been huge professionally to keep current with the latest research while on the road. I like the feeling of ASN as a home with my professional family, where I can reach out to other members with questions, to look for answers from scientists and researchers who may have experience in those areas. I also find networking opportunities at ASN as a huge benefit, feeling confident that ASN members have received the quality training I’m looking for, to get their opinions and perspectives. I’m excited to see the use of networking tools like ASN NutriLink to get the conversation started about topics of interest by the community. I also feel I can trust the opinions of other ASN members.

4. What aspects of your research do you foresee being most important for ASN members?

After my formal training in nutrition, as a postdoc, I had the opportunity to gain advanced training in psychology and child development. While those fields were very different than mine, I now have an understanding of best practices in the fields of nutrition, psychology, and child development. I learned about processes and techniques from psychology and have been able to marry them with those used in nutrition in order to conduct research which furthers our understanding of the association between micronutrient levels and cognitive outcomes. I think that multidisciplinary techniques need to be employed to examine the complex problems that we are trying to understand today and I’d like to see more ASN members incorporate best practices and findings from related fields in their research. My hope is that our research findings will help to improve global health for everyone. Solid, evidence-based, scientific discoveries will be a catalyst for shaping health policies globally.

5. Can you tell us more about your current position and the research activities in which you are involved?

I work as Associate Professor, which entails research, teaching, and service–as s a land grant institution, Penn State is committed to service. I teach both undergrad and graduate courses in Advanced Nutrition and Metabolism, Pathophysiology, Epidemiology, and Global Health. I also help train graduate students in the lab, with a large undergrad group of students in honors classes and volunteers. My research activities are both overseas and in the US. While most of my field research is overseas, mechanistic studies are primarily at Penn States, where we have state of the art equipment to help identify what’s going on in the brain. The majority of my research work is with iron deficiencies, either with the mom or child, and on behavior and cognitive development. My geographic research areas are Africa, Southeast Asia, and South America.

6. What do you feel are the biggest challenges facing nutrition researchers today? Are there any areas where you would like to see more research?

Because nutrition is an interdisciplinary field, the main challenge is with regard to funding at all levels, thus we need to ensure that funders understand the importance of nutrition research. Another challenge is that people from all sorts of backgrounds claim to be nutrition experts and they don’t necessarily convey evidence-based nutrition, thus confusing the message about what is good nutrition.
The microbiome is an area ripe for research, where there’s a lot of promise. There’s a particular rising interest in the gut-brain axis. However, we should be cautious about interpretation of research findings. Change is not necessarily bad; we need more research before we can properly characterize the changes that we observe in the microbiome under various experimental conditions. There is so much to learn.

7. Is there anything else you’d like to tell ASN members, especially students and postdocs?

My biggest piece of advice is for everyone, especially young scientists, to be rigorous about research; don’t take shortcuts. We need to do good science–do your homework, don’t be in a hurry, take your time, slow down, and read the literature. We must be rigorous about what we do and follow the scientific method. Our findings will have a lifelong impact on health. We need to learn from the past to keep moving forward, despite challenges from people claiming to be “nutrition experts”. I encourage students and postdocs to get involved, and to volunteer with ASN, and not be afraid to ask questions. Being active in the society will help you to make connections and learn from those who have experience. Pass it on, learn from others and give back to help those behind you!

Dr. Murray-Kolb’s research interests include micronutrient deficiencies (assessment, causes, neurocognitive/neurophysiological/behavioral consequences, prevention), maternal and child interactions, child development, cognition and affect, biofortification, iron, anemia, and international health.

Interview with Robert Bertolo

April 2017 Member Highlight Interview for ASN Nutrition Notes eNewsletter:

Interview with Robert Bertolo, Professor, Department of Biochemistry, Memorial University of Newfoundland, Vice Chair of ASN Publications Management Committee, and Immediate Past President of the Canadian Nutrition Society

Dr. Bertolo has been with the Memorial University of Newfoundland since 2002. He trained at the Universities of Guelph and Alberta studying nutrition and metabolism during development with a focus on amino acid and protein nutrition. As a Professor of Nutrition and Metabolism and Canada Research Chair in Human Nutrition, his current research involves the neonatal use of amino acids for growth and non-growth requirements.

1. How did you first get involved in biochemistry and nutrition? What made you interested in the field?

My undergraduate degree was in liberal arts with a minor in biochemistry and when it came time to choose my honours thesis topic, a course in nutritional biochemistry by Stephanie Atkinson piqued my interest. The work in the lab was exciting and that environment felt like home. So I started my MSc at Guelph in nutrition shortly thereafter and never looked back. What I really enjoyed about studying nutrition and metabolism is the combination of mechanisms with real world applicability. Anyone who eats is a self-declared expert in nutrition so the field is uniquely influenced by the public and is very dynamic. There’s always so much to learn, and even more to teach.

2. When and why did you first join ASN? What convinced you to join the organization?

As with most of us, I first joined ASN as a graduate student to get connected with the network of researchers and to present our data. It’s a testament to ASN’s support of trainees that we all join so early. My first EB was an unforgettable experience of excitement, nerves, intellectual stimulation and fun. Presenting to the names on your reference list is quite the experience, but also realizing they’re all just regular folks made it so rewarding. After that first conference, ASN became the home base for networking with international experts and learning about many other disciplines within nutrition.

3. What aspects of ASN membership have you found most useful, professionally? What other aspects of your membership do you find useful as your career has progressed?

Probably the most important asset to membership is the networking opportunities with nutritionists from around the world. ASN is the gathering place for nutritionists from around the world and it allows you to learn about peripheral topics in nutrition so you don’t get consumed by your own little niche. A key part of this networking is getting involved in ASN activities including RIS events, committees, judging, etc. That’s really where you meet wonderful people of all career levels and from various disciplines. Many collaborations (and friendships) are started in the hallway between sessions or at a poster or at a break during the committee meetings. The world of research today is all about team effort, so these connections are key to research success.

4. How do you see ASN’s role in the nutrition community?

I was president of Canadian Nutrition Society shortly after it too was formed from the merger of nutritional sciences and clinical nutrition societies. ASN was a model we used to build a community of nutritionists with different goals and priorities. We admired ASN’s ability to grow and be strong, while at the same time taking risks and constantly looking for opportunities. It was because of our similar goals that we established a joint membership opportunity and we continue to collaborate. And beyond Canada, ASN has made it a point to link with many nutrition societies internationally which is a testament to their role as global leaders.

5. Can you tell us more about your current position and the research in which you are involved?

I am full professor at Memorial University of Newfoundland, which is on the eastern edge of North America. It is a mid-size university in a beautiful location with a great collaborative atmosphere. For research, I am interested in amino acid metabolism and how it affects requirements in different situations. Currently, I am trying to determine how neonatal nutrition and methyl metabolism affect programming of risk for developing obesity and hypertension. From a nutritional perspective, my question is how much methionine is needed to maintain growth and methylation demands and which pathways take priority when nutrition is inadequate. We have some exciting data on the non-protein pathways of methionine and are able to quantify these fluxes using tracer kinetics. I also have other research on amino acid requirements during intestinal stress, such as in parenteral feeding and short bowel syndrome. Overall, I try to conduct all of my research by building a team of experts to enhance the research questions and outcomes. I feel this is the key to research success.

6. What do you feel are the biggest challenges facing nutrition researchers today? Are there any areas where you would like to see more research?

The funding climate has become very difficult, especially for young researchers. There is a short-sighted emphasis to funnel more money to the top researchers which starves the more modest base. I think the key for young nutrition researchers is collaboration and to lead team approaches to big ideas. Don’t be afraid to have someone take you out of your comfort zone; we’re to learn after all. In terms of areas of future research, I think we need more understanding of nutrition behaviours and food environments. We have known for a long time what we should eat to be healthy, but we can’t seem to convince the public to do it. I am also concerned about food insecurity in North America and more work at the policy level is needed resolve this issue. And all of this relates back to the obesity epidemic, which is a very modern issue that has eluded effective solutions.

7. Is there anything else you’d like to tell ASN members, especially students and postdocs?

I think the key message for trainees is to get involved. There are many opportunities out there that could lead to something great. Almost none of us foresaw our current path as students and so trying to plan a specific outcome is just not realistic. Get involved in ASN and other societies and meet people. Most of us are where we are after a chance meeting with someone at the right time and that happens by getting out there. So get involved!

Editor’s Note: Under Dr. Bertolo’s leadership, ASN and CNS began offering joint memberships in 2015.

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Interview with Juan Rivera Dommarco

March 2017 Member Highlight Interview for ASN Nutrition Notes eNewsletter:

Interview with Juan Rivera Dommarco, Director of the National Institutes of Public Health (INSP) of Mexico, President of the Latin American Nutrition Society (SLAN), and Executive Board Member of the Ibero-American Nutrition Foundation (FINUT)

Dr. Rivera is the newly appointed Director of the National Institutes of Public Health, where he has been since 1993. There he founded the Center for Research in Nutrition and Health in 2001. He is also Professor of Nutrition in the School of Public Health of Mexico and Adjunct Professor at Emory University. Dr. Rivera has published more than 400 scientific articles, book chapters, and books, and made more than 500 presentations and conferences at scientific events. He is past recipient of the Kellogg International Nutrition Research Award from ASN, granted for active engagement in research to benefit populations in nonindustrialized countries, as demonstrated through publications in the scientific literature, and actively engaged in training new scientists for international nutrition research.

1. How did you first get involved in nutrition epidemiology and research? What made you interested in the field of nutrition science?

My original motivation was poverty and inequity. Most Latin American Countries, including Mexico have profound inequities. Since childhood, I felt social inequalities were morally wrong. During high school, I read several books about social injustice, including Josue de Castro’s recounts of inequity, and a direct indicator of inequity was hunger and undernutrition. After high school, I spent some time in an indigenous community in Chiapas, where I witnessed poverty very closely. That is when I decided to devote my life to fight undernutrition, hunger, and their health effects. My undergraduate training was in nutrition and food sciences at the Universidad Iberoamericana, a Jesuit University in Mexico City with a mystic about poverty alleviation. I did my internship training with Dr. Joaquín Cravioto, a prominent Mexican scientist interested in undernutrition and mental development. He inspired me to become a nutrition scientist. I started reading the works of Scrimshaw, Habicht, and Martorell at INCAP in Guatemala and I corresponded with Jean-Pierre Habicht, who invited me to visit the Division of Nutritional Sciences at Cornell. After my visit, I decided to undergo postgraduate training in Nutrition at that University.

2. When and why did you first join ASN? What convinced you to join the organization?

I was first introduced to ASN in 1983, while I was a graduate student at Cornell University, and I officially became a member in 1991. My Committee Chair and mentor, Jean-Pierre Habicht, considered as part of the training of his students to attend the then called FASEB Meetings to present the results of our research. As many other of his students, I joined ASN and attended the meetings.

3. What aspects of ASN membership have you found most useful, professionally? What other aspects of your membership do you find useful as your career has progressed?
I appreciate the opportunity to keep up-to-date about new knowledge in the area of global nutrition, along with the high quality of the research results presented and lively discussions at Experimental Biology. I also advocate for ASN journals, in which I have published repeatedly, and I enjoy the opportunity to meet with colleagues and old friends during ASN meetings, where we often discuss new research and explore collaborations. More recently, ASN meetings have exposed my students to high quality works and allowed them to share the results of their studies with other nutrition scientists.

4. What aspects of your research do you foresee being most important for ASN members?

In Mexico, we face the double burden of undernutrition and obesity; therefore, we are conducting research aimed at solving these two problems, which together are of great interest to the Global Nutrition Council and to much of the ASN membership:
 We have been monitoring the magnitude and trends of the double burden of malnutrition in Mexico during the last 30 years through national nutrition surveys.
 We are conducting birth cohort studies looking at the relationship between maternal feeding and weight status and gain during gestation, as well as infant feeding practices and several outcomes at different points in time during childhood and adolescence, including appetite and satiety, growth, weight gain, cardiometabolic risks, and neurodevelopment.
 We are also generating knowledge for the design of policies for the prevention and control of the double burden of malnutrition, including programs for the prevention for stunting, anemia, and micronutrient deficiencies and policies for the prevention and control of obesity, including fiscal measures and school regulations, among others.
 Finally, we are conducting evaluations of the effects of several programs and policies applied by the Government for the prevention and control of the double burden of malnutrition.

5. Can you tell us more about your current position and the research activities in which you are involved?

On February 16, I was appointed as Director General of the Mexican National Public Health Institute (INSP), the research and training institution that houses the Mexican School of Public Health. We conduct research in several public health topics including: nutrition, obesity and non-communicable chronic diseases, infectious diseases, environmental health, health systems research, reproductive health, health promotion, etc. and we offer twenty-eight Masters and PhD programs. We have around 1,200 employees and close to 500 students in three campuses. I am personally involved in the research activities mentioned above: monitoring the double burden in the population, birth cohort studies to assess the effects of infant feeding practices, generation knowledge for the design of policies for the prevention and control of the double burden, and evaluating the effects of some of those policies applied by the Government.

6. What do you feel are the biggest challenges facing nutrition researchers today? Are there any areas where you would like to see more research?

One of the biggest challenges in Public Health Nutrition is translating research results into clinical and public health large-scale interventions and their rigorous evaluation for further improvement. To do this we need research from subcellular particles (molecular biology) to programs and policy. This includes linking the wealth of information coming from basic research, particularly from molecular biology, to clinical and public health innovative actions. We also need to study the drivers and determinants of the double burden of malnutrition and its health and environmental consequences using a systems approach, since nutrition problems are multifactorial and complex. We need to understand the food system but also the factors influencing behaviors (food and physical activity). We also need to study how to influence sound policy-making, including the roles of direct advising to policy makers and of social mobilization to generate demand for policy. Finally, we need to conduct rigorous evaluations in order to inform policy makers about improvements in current policies.
March 2017 ASN Nutrition Notes Member Highlight
Interview with Dr. Juan Rivera Dommarco – Page 3

7. Is there anything else you’d like to tell ASN members, especially students and postdocs?

To Students and postdocs: The phrase “First do no harm” (Latin Primum non nocere) is believed to have been part of the original Hippocratic oath taken by physicians. We nutritionists do not take a similar oath, but we should. You have the privilege to be a fraction of people in the world who have access to postgraduate training. You chose Nutritional Sciences, a field that can have a profound impact on the health and wellbeing of millions of people. You should be generous, because life has been generous to you. You should pay back to those in poverty, to the neediest persons in the world, for the privilege to have reached postgraduate training, in an activity that can change the lives of many. However, most importantly, do not harm the nutrition and health of people by promoting or endorsing unhealthy food and beverage products. To the general ASN membership, I would like to invite you to attend the SLAN Congress in Mexico in late 2018, showcasing the best nutrition research from Mexico and Latin America.

Dr. Rivera’s research interests include the epidemiology of stunting (under-nutrition and obesity), the short- and long-term effects of under-nutrition during early childhood, the effects of zinc and other micronutrient deficiencies on growth and health, the study of malnutrition in Mexico, and the design and evaluation of policies and programs to improve nutritional status of populations.

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Soda Politics: A Discussion with Dr. Marion Nestle

By Chris Radlicz

Marion Nestle, PhD, MPH is Paulette Goddard Professor in the Department of Nutrition, Food Studies, and Public Health at New York University, which she has chaired from 1988-2003. Additionally, she is Professor of Sociology at NYU and Visiting Professor of Nutritional Sciences at Cornell. Dr. Nestle earned her PhD in molecular biology and MPH from University of California, Berkeley. Her research examines scientific and socioeconomic influences on food choice, obesity, and food safety, with an emphasis on the role of food marketing. She is the author of several prize-winning books, and in her latest, Soda Politics: Taking on Big Soda (and Winning), Dr. Nestle provides insight on the soda industries tactics to gain consumers and addresses what is now working in the fight against ‘Big Soda’. I recently had the opportunity to ask Dr. Nestle some questions relevant to her newest book.

1. How has your background in molecular biology lead you to your career interest in public health, and particularly food politics?

The direct story is that I was teaching undergraduate molecular and cell biology in the Biology Department at Brandeis University and was assigned a nutrition course to teach. Undergraduate biology majors wanted a course in human biology and it was my turn to take one on. From the first day I started preparing that course, it was like falling in love. I’ve never looked back. Politics was in the course from day one. It’s not possible to understand how people eat without understanding the social, economic, and political environment of food marketing and food choice.

2. What lead you to write your newest book, “Soda Politics: Taking on Big Soda (and Winning)”?

I’ve been writing about soda marketing since the late 1990s when I learned about “pouring rights” contracts–soda company arrangements with educational institutions for exclusive sale of their brand. These started with colleges but had just gotten to elementary schools when I learned about them.  Since then, I’ve followed Coke and Pepsi marketing with great interest.  I teach food politics and food advocacy at NYU and was well aware of all the advocacy groups working to reduce soda intake as a public health measure.  When my agent suggested that I ought to write a book about sodas, it seemed like a terrific idea to encourage readers to engage in advocacy for healthier food systems.  Sodas are a good example of how to do this.

3. The title is provocative. Why do you say that those taking on ‘Big Soda’ are in fact ‘winning’?

That’s the best part.  Soda sales are way down in the United States. The soda industry thinks public health advocacy is responsible, and who am I to argue?

4. What has influenced the slow but successful decline in soda consumption seen today?

Excellent public health advocacy. Think of New York City’s poster campaigns over the last four or five years. These illustrated the amount of sugar in sodas and how far you would have to walk to work off the calories in one vending machine soda

5. The Coca-Cola funded non-profit, “Global Energy Balance Network”, recently shut its doors. Do you think this is evidence of gaining momentum?

Reporters from the New York Times and the Associated Press were shocked to discover that Coca-Cola was funding university research to demonstrate that physical activity is more effective than eating healthfully in preventing weight gain.  This idea is patently false. Investigations revealed that the researchers worked closely with Coca-Cola executives to craft the research, conduct it, interpret it, publish it, and present it at meetings. This too seemed shocking. Now Coca-Cola is scrutinizing who it supports and many organizations know they need to be more careful to avoid such conflicts of interest.

6. In what ways do you see parallels in tactics used by ‘Big Soda’ and those previously used by cigarette companies in defending their respective products?

Soda is not tobacco but the tactics sure look similar. The soda industry follows the tobacco industry’s playbook to the letter. It too attacks inconvenient science, buys loyalty, funds front groups, lobbies behind the scenes to get what it wants, and spends fortunes to oppose public health measure that might reduce soda intake.

7. Where can people follow your current work and get involved in this fight against ‘Big Soda’?

I write an (almost) daily blog at www.foodpolitics.com where I cover such issues. Soda Politics has an Appendix that lists the principal advocacy groups working on soda issues and provides links to their websites.  It’s easy to get involved in food advocacy and well worth the time.

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Path to Policy: Interview with Angela Tagtow, Executive Director of the Center for Nutrition Policy

By: R. Alex Coots

The field of nutrition is diverse. Some nutrition researchers pursue their work to better understand human metabolism, while others seek to help people build healthy eating habits. Despite the different approaches in their research programs, nutrition researchersall aim to improve public health. But simply producing the information isn’t enough. The entirety of scientific knowledge must be evaluated and used to create effective policies to fully realize the benefits of nutrition research.

Angela Tagtow, Executive Director of the Center for Nutrition Policy and Promotion at the USDA, continues an illustrious career in health promotion at the USDA. She’s worked in nutrition, public health and food systems at levels ranging from local initiatives to international endeavors. She and I had a conversation about her career, her advice for students interested in policy, and her thoughts on the challenges of policy work.

How did you get your start in nutrition and policy?

Growing up, food and meals were very important in my family. We maintained a large garden which provided diverse foods for our day-to-day meals. In college I had an intense interest in health promotion, but clinical dietetics was focused on treatment rather than prevention of illness. Health promotion at the time was nascent but I saw the potential and oriented my life towards it.

After graduation from college I started work at the American Heart Association as a program director. This position helped build out my network and gave me my start in the health promotion world, however I quickly realized I’d need graduate-level training to take my career further. After graduate school I started work as a consultant in the WIC program at the Iowa Department of Public Health. Here I worked more broadly in the public health domain with a variety of groups such as the county boards of health and Title V Maternal and Child Health Services.

After 9 years, I decided to expand my areas of expertise to include food systems as well as public health and nutrition. I founded a consulting company where I provided education, informed policy, and developed communication tools around health, the environment, and food systems. After 9 years of consulting, I moved back to government to work at the CNPP.

What are the key lessons or skills that you took away from these endeavors?

Consulting work affords you a good deal of flexibility in the types of work that you take on. I was able to broaden my skillsets, increase my knowledge base, and diversify my network in ways that I wouldn’t have been afforded in government. Consulting does have a bit more uncertainty with respect to job security. A career in government is a much different experience. The scope of the work is more defined and the position is more secure compared to consulting, but it may be difficult to advance upward.

The key skillsets that today’s students should focus on are critical thinking, communication, and engagement. As dietitians and nutritionists, we need to feel comfortable being assertive and asking the difficult questions. Of these three skills, engagement and networking are the hardest to teach. Students should continually practice this skill throughout their careers. Networking is something that takes time and is an ongoing learning experience.

When creating nutrition policy, are particular data or data types more useful than others?

All of the different data types must be considered, especially systematic reviews and randomly controlled trials. We need to be looking at the preponderance of data to reach a conclusion, not create policy based on one particular study or study type, as each type of study has strengths and weaknesses. After evaluation of the data, we have to be able to translate the body of research into appropriate policy or interventions. Policy is like a puzzle and data are the pieces.

Do you feel that there’s siloing of academic fields, and that crosstalk can improve health outcomes?

There’s still some siloing of research topics, but there has been improvement. Some land grant institutions with great agricultural research programs focus on food production or food processing issues, but this work is not necessarily connected to the greater picture of human health. Some schools have recognized this issue and have started interdisciplinary programs aimed towards interconnectivity – programs in food systems is a good example. People have recognized the value of an integrated approach, but it’s a process that takes time to develop.

Part 2 of this interview will be posted in my next entry.

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Interview with Andrew Brown, PhD

By Allison Dostal, PhD, RD

The relationship between nutrition and health is fully entrenched in the mainstream media – everyone from career scientists to our next door neighbor seems to be an expert on the topic. Trained health professionals and researchers do our best to deliver credible information, but it’s all too easy for clear messages to get lost in the constant stream of 30-second sound bites.

Dr. Andrew Brown, a Scientist with the University of Alabama-Birmingham’s Nutrition Obesity Research Center (NORC) & Office of Energetics, is focusing his current work on illuminating common misconceptions in the field of nutrition and increasing awareness of media perspectives and biases. I recently had the opportunity to ask him a few questions related to research integrity, science communication, and being a part of the next generation of nutrition researchers and educators working to effectively deliver nutrition information in the Digital Age.

Tell us about your work with NORC and the Office of Energetics.

The majority of my work is in the field of meta-research, which can involve investigating what was studied, why it was studied, and how it was studied. In addition to the more common forms of meta-research, like systematic reviews and meta-analyses, I look at the way that research is conducted, the quality of reporting, analytical choices during statistical analysis, and from where nutritional zeitgeist comes despite little strong empirical evidence.

How did you become interested in calling attention to myths, presumptions, and reporting accuracy of nutrition research?

As a student studying lipid chemistry, I noted that most lipid biochemists (as well as many others) recognized that dietary cholesterol had little impact on blood cholesterol, and yet cholesterol-containing foods were demonized. During my doctoral degree, I attended the Office of Dietary Supplements’ Research Practicum, where I anticipated learning what was and was not known about the health impacts of dietary supplements. Instead, and to my benefit, much of the talk was about limitations of current research, regulatory limitations, and differences in philosophies about how diet – and particularly supplements – could be studied. Claims about dietary cholesterol and supplements are just some of the dietary beliefs that are either completely refuted by our best science or at best weakly supported; yet, many people within and beyond the nutrition science community believe them. Thus my interest is at least two fold. The first is trying to determine which beliefs I hold that are not supported by the evidence, such as the relationship between eating/skipping breakfast and obesity. The other is to help communicate the state of science to hopefully decrease confusion.

With the attention that your research group is calling to this movement, how do you see publication and the media’s attention to nutrition changing in the next 5-10 years?

I am optimistic that nutrition science will continue to improve, including more discussions of the nuances of nutrition science rather than speaking in absolutes. If we ‘know’ that sugar is bad, or polyunsaturated fats are good, or that breakfast prevents obesity, then there is nothing left to study. Because of human heterogeneity within ever-changing local and global environments, it is unlikely that there is one diet or one set of recommendations that is appropriate for everyone and every situation, even for essential nutrients. Population-level recommendations are great place-holders until we develop more refined recommendations for individuals, subgroups, food-types, food-compositions, and other aspects of diet.

In a recent ASN blogger interview with Paul Coates, the Director of the NIH Office of Dietary Supplements, he stated with regard to the aging of the nutrition researcher population, “A fairly urgent challenge is identifying people who can come up behind us and continue to identify opportunities for research—particularly those that have public health implications— and be committed to help tackle them.” What are your thoughts on strategies for engaging young nutrition researchers in scientific discourse? How can young researchers take part in a dialogue with fellow scientists, the media, and the public to improve communication and perception of nutrition research?

I think we need to keep our eyes open for promising individuals that we can trust to think scientifically and ethically, and help them grow in a tailored way. The increased use of Individual Development Plans seems to be a great step in this direction, as is putting a maximum number of years on post-doctoral training, with the idea that a post-doctoral position is for additional training, not for an indefinite job. I have been extremely fortunate to have had mentors that gave me opportunities to speak, develop ideas, and truly contribute to teams and discussions throughout my formal education, as early as my freshman year. I was encouraged to write grants, publish, and complete other essential activities in the business of science, but my mentors focused very much on teaching me how to ask scientific questions; read the existing literature; develop critical scientific thinking skills; communicate with precision; and conduct good science.

On the side of mentees and students, I think it is important to be inquisitive while being willing to admit if you don’t know something. Stating confidently something that is false is a great way to lose trust and be excluded from the discussion. Instead, ask for clarification; add information to the conversation that might be useful; and, most importantly, don’t force yourself into discussions just to be noticed.

I also think it is important to move away from research focusing so heavily on public health (with the full disclosure that I work in a School of Public Health). Improvements in the public’s health is a noble and lofty goal, but to come into a study with the assumption that the outcome will result in an improvement in public health (particularly the entire population’s health) encourages overstating of results, misinterpretation of data, and doubling-down on dietary preconceptions. In science, the focus needs to be on determining some form of objective truth or lawful relationship. If we can identify these truths and relationships, then ways to improve public health will become self-evident, with the understanding that policy decisions are based on value structures beyond scientific evidence.

What advice do you have for graduate students and early career investigators?

Make sure you are doing something you love, that you do it to the best of your ability, and that you do it with the highest integrity. Be sure anything you put your name to is something that you are willing to take credit for, but also understand that this means you will be responsible for shortcomings of the work if problems are discovered later. And always be willing to entertain and evaluate an idea, especially one you disagree with or find unpalatable; these could be the very ideas that lead you to new lines of work, may help you better communicate your ideas to those who disagree with you, or might even overturn your entire view on a subject. As Aristotle said, “It is the mark of an educated mind to be able to entertain a thought without accepting it.”

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The Path to Policy: ODS Interview

Interview with NIH Office of Dietary Supplements Director Dr. Paul Coates

By: R. Alex Coots

Academia is changing.

Today’s universities increasingly rely on adjunct faculty to teach courses and reserve the coveted full-time academic position for the science superstars. This phenomenon, coupled with decreasing paylines from funding agencies, makes a science career especially challenging to pursue. And that’s not even considering the project difficulties!

The problem has become so pressing that even the NIH has realized it. New initiatives, such as the BEST Innovation Award, aim to ensure that graduate students and post-docs have increased opportunities to expand their skill sets for a future outside of academia.

Policy is one of the many areas that nutrition experts can serve. The current Director of the Office of Dietary Supplements (ODS), Dr. Paul Coates, successfully made the transition from bench research as a geneticist to a career in science policy. He spoke with me about his career and transition to ODS.

What motivated your interest into policy?
I was curious. For all these years, I had been funded to do research by the NIH and other organizations, but what I concentrated most on was my own research. I was pretty naïve when I came to the NIH, not knowing what life was like for people who worked on the government side. There were plenty of them like me, PhD’s in one setting or another, who had come to the NIH to work as extramural program directors.

What are the important skills or knowledge that someone should have when moving into policy?
One of the things I understood was the importance of making connections. My first job at the NIH was focusing on diabetes research efforts. I learned how to work with other people within an institute, and then gradually in other institutes and beyond to achieve common goals. I think the art of science policy is knowing who else works in this field that you can benefit from, and flip it around and ask “How can I help other people benefit from working together with them?” Recognize the talent that’s out there in other organizations.

What advice would you give to students?
You need to pay your dues as a scientist first. You need to understand the scientific method. You don’t have to spend an eternity in science, but you must have spent some time doing it. Author publications and write grants. My observation is that the people best prepared for this kind of experience “get it” about what a scientist does. They must be prepared to critically analyze data and know what to look for in the literature to inform policy.

What types of projects do the AAAS and Milner fellows work on?
The AAAS Science and Technology Policy Fellowship is beautifully designed to encourage people at different levels of experience in science to work closely with federal agencies to learn about the science-to-policy transition. In ODS, we’re recent partners in that program. Fellows are engaged in projects that my office works on. We have a very active role in translating science into policy, but also in identifying research needs.

The Milner fellowship has a different side to it. Jointly funded by ODS and the Beltsville Human Nutrition Research Center, the Milner fellowship brings in one or two people per year for a two-year stint that will allow them to conduct research in one of the labs at Beltsville. At the same time, they participate at ODS in work on science policy.

How do you see ODS changing in the future?
ODS is getting a little older. A fairly urgent challenge is identifying people who can come up behind us and continue to identify opportunities for research—particularly those that have public health implications— and be committed to help tackle them.

ASN’s Dr. John Courtney Outlines Growth, Future Plans

A Conversation with ASN Executive Officer John E. Courtney, PhD
By Teresa L. Johnson, MSPH, RD

The smile on Dr. John Courtney’s face says it all: ASN’s Scientific Sessions and Annual Meeting at EB 2015 is the place to be. Courtney, who is in his ninth year as ASN’s Executive Officer, sat down with me on a sunny afternoon in Boston and chatted about the meeting and ASN’s current and future status.

TJ: What’s your favorite thing about ASN’s Annual Meeting?
JC: It’s so great for bringing together the wide, diverse audience of ASN in one central convening area. We have members in basic, clinical, and translational nutrition, and they’re housed in academia, medicine, practice, and industry. So it’s exciting to give people an opportunity to develop and build partnerships and work together, not only to advance the science but their personal careers too.

TJ: Tell me about the changes ASN members can expect to see in 2018.
JC: ASN will convene a nutrition-focused Scientific Sessions and Annual Meeting for three years beginning in 2018. EB has been a great forum for people to work within, but we think that having a nutrition-focused meeting brings together members of the nutrition science community where they can all meet and convene. It will be a smaller meeting so it will be more open to networking, less confusing, and have less competition for scheduling to allow productive connections. I envision us having a lot more flexibility in how we structure our meeting. We’ll probably do it outside the academic year, and we’ll do it in a cool place!

TJ: What are you hearing from the members regarding this change?
JC: There’s been great support from our members, and a lot of excitement. Of course, our current president, Dr. Simin Nikbin Meydani (pictured below with Dr. Courtney) of Jean Mayer USDA HNRCA at Tufts University, is a fantastic leader with great skills in consensus-building. If you make changes, you really have to go the extra mile in seeking input and cultivating agreement, and she’s done that.

TJ: How will ASN maintain the same level of quality in its meeting?
JC: A lot of questions have been raised about how we can do it the best way. Some people are concerned because they like the EB model—they like the “cross-fertilization” of scientific disciplines—so one of the things we’re hearing loud and clear is that we need to keep that cross-fertilization. So we’ll offer programming that meets all the segments of ASN’s needs.

TJ: What will be unique about ASN’s meeting?
JC: I see us having a lot of different types of activities. We can take a look at how to offer sessions that reach out to the public. Right now we reach the researchers and the practitioners, but we want to take that next leap and start to engage the public.

We’re also planning sessions that are unrelated to nutrition. Maybe we’ll hear about the newest, hottest thing in the future of information technology or the potential role that robotics can play in personalized health!

Perhaps we’ll have an inspirational session that brings in that spectacular leader or renowned speaker who says, “This is what the world is going to look like in 2050,” and asks, “How can people working in nutrition prepare for the challenges and the opportunities that will be taking place then?”

TJ: How is ASN poised to address the next five years?
JC: We have a strategic map that focuses on positioning ASN as the global authoritative leader in nutrition science. We have an actionable dashboard that identifies what our key problematic areas are and we’ve developed strategies that fit and help us meet those challenges.

For example, one of the exciting strategies that our incoming president Dr. Patrick Stover, Cornell University, wants to focus on is positioning ASN for 2028—the 100th anniversary for the Society. So, rather than looking at what we want to be in five years, we’re asking what we want to do and be in 2028; then we’re breaking it into chunks that will get us there. We’re looking at an endpoint to best add the most value.

TJ: What kinds of initiatives do you anticipate ASN will launch here in the US and abroad?
JC: I expect we’ll have a lot more topical meetings throughout the world. We have meetings now in the Middle East, Central and South America, and Asia, but I see us really taking off so that ASN will have a presence in every major continent in the next five years. Although we have that presence now with members, we don’t offer a lot of programming outside of the States so that’s what we want to do—develop programs that meet those members’ needs and grow even more.

TJ: Will ASN still be called “American Society for Nutrition”?
JC: That’s a great question! We’ve dialogued about that and had a lot of good feedback about it. I don’t envision us changing ASN—I really don’t—but we’re a volunteer organization, and if our volunteers should wish to change it, perhaps we’ll simply refer to ourselves as “ASN.” When we say our name, we each have some vision of what that means, but what we really are is a global organization. We have over 5,200 members in 72 different countries, and approximately 28% of the meeting attendees are from outside the United States. Clearly we’re drawing a global audience.

TJ: What keeps ASN relevant?
JC: ASN really is the global leader in nutrition science. Our members, our authors, and our speakers are the preeminent leaders in nutrition. They’re the ones researching today’s problems, disseminating that research through our publications and our meeting-related activities, and then taking it and translating that to dietitians, medical practitioners, and public health advocates.

ASN is really on the move. We’ve more than doubled our membership, outreach, staffing and budget in the last 10 years. In the next 10 years I think we’ll see equivalent growth in terms of our revenue and our member service activities, so we’ll have more interaction on a grander scale.

For a first-person take on Dr. Courtney’s management style, watch his video interview with CEO Update here.