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Dr. Stover graduated from Saint Joseph’s University with a B.S. degree in Chemistry and was awarded the Molloy Chemistry Award at graduation. He received a Ph.D. degree in Biochemistry and Molecular Biophysics from the Medical College of Virginia and performed his postdoctoral studies in Nutritional Sciences at the University of California at Berkeley. Patrick Stover was elected into the National Academy of Sciences in 2016. In 2014, he was elected as a Fellow of the American Association for the Advancement of Science. He also he received the SUNY Chancellor’s Award for Excellence in Scholarship and Creative Activities and the Osborne and Mendel Award for outstanding recent basic research accomplishments in nutrition from the American Society for Nutrition.

In 2012, he received a MERIT award from NIH’s National Institute of Diabetes and Digestive and Kidney Diseases and in 1999, he received the E.R.L. Stokstad Award in Nutritional Biochemistry from the American Society for Nutritional Sciences. In 1996, Patrick Stover received the Presidential Early Career Award for Scientists and Engineers from President Clinton, the highest honor bestowed by the U.S. government on outstanding scientists and engineers beginning their independent careers, and he has been selected as an Outstanding Educator four times by Cornell Merrill Presidential Scholars. He also serves as Editor for the Annual Review of Nutrition.

How did you first get involved in nutritional biochemistry and research? What made you interested in the field of nutrition science?

I caught the research bug through an undergraduate research experience at Saint Joseph’s University. Dr. Nelson’s research group was funded by the Naval Air Development Center and focused on the design, synthesis and function of synthetic prostaglandin oligomers as anti-ischemic agents. Studying the role and biological function of small nutrients became my passion and drove my interest in metabolism and biochemistry. I then studied enzymology and folate metabolism for my doctoral research under the mentorship of Dr. Verne Schirch at the Medical College of Virginia. This experience naturally led to an interest in nutrition and my migration to the University of California at Berkeley, when I studied folate nutrition and metabolism in the research group of Dr. Barry Shane.

When and why did you first join ASN? What value does ASN continue to provide you?

I joined ASN much later than I should have. I had regularly attended Experimental Biology and participated in ASN programming since graduate school but was most active in ASBMB. I joined ASN in1999 shortly after I was tenured as an associate professor, initially due to my interest in graduate education. I joined the Graduate Nutrition Education Committee and rose to rank of chair when we published what I believe is still a very important resource for all nutrition graduate programs: J Nutr.2002 Apr;132(4):779-84. ASN became my academic and professional home over the years—where I see old and meet new colleagues and collaborators, where my students present their research findings, where I developed leadership skills, and where I give time and treasure back to the nutrition community.

What aspects of ASN membership have you found most useful, professionally for you, your faculty and students? What other aspects of your membership do you find useful as your career has progressed?

All science is now a “social” science—collaboration is critical to address most important research questions. No one can succeed in a vacuum. Understanding how to forge meaningful and constructive partnerships through collaboration is essential to success, and ASN offers numerous opportunities to bring scientists together in an environment that promotes the exchange of ideas. Importantly, ASN also actively promotes mentoring opportunities for students and junior scientists, which has been invaluable for my students.

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

My bias is that nutrition, in all its dimensions, behaves as a complex dynamic system, and system approaches are needed to provide solutions to the problems we seek to solve. Hence, many of my current collaborators are those expert in systems biology and computer science.

Can you tell us more about your new position and what you hope to accomplish?

Perhaps the greatest challenge of our time is harmonizing agriculture, food systems, human health and environmental health. This is essential to address skyrocketing diet-related health care costs, environmental deterioration, and to ensure sustainability of our agriculture systems. Texas, as a national leader in agricultural production, coupled with its Healthy Texas A&M AgriLife Extension initiative, will be a model for aligning healthy and profitable agriculture with healthy people and healthy environments. As Vice Chancellor and Dean of Agriculture and Life Sciences at Texas A&M University and System, I have the privilege of working with the talented faculty, academic staff, students, state-wide agencies and stakeholders to be a national model for excellence in meeting the one-health challenge through research, teaching, Extension and service.

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

For the students and trainees, do what you love and you’ll love what you do! Strive to become a world-class expert in your field and enjoy as many colleagues as you can. Share your ideas with others, and they will share openly with you. Give back to the community that has given so much to you…perhaps through the ASN Foundation!

 

The Stover research group investigates the chemical, biochemical, genetic and epigenetic mechanisms that underlie the relationships between one-carbon metabolism and human pathologies including neural tube defects, cardiovascular disease and cancer. Specific interests include the regulation of folate-mediated one-carbon metabolism and genome expression and stability, the molecular basis of the fetal origins hypothesis, development of mouse models to elucidate mechanisms of folate-related pathologies, and translational control of gene expression.

 

One of the best feelings is when you get a good night’s sleep and feel refreshed to take on the day. Unfortunately, many of us (especially us graduate students) stay up too late and wake up too early, which leads to not enough sleep and/or poor sleep quality. However, getting enough sleep may be an important health habit to prioritize since research has suggested there is a link between sleep and nutrition.

Recently, a study that found a negative correlation between sleep and sugar consumption has been getting a lot of media attention. In this study, researchers from King’s College London recruited 42 healthy participants who reported frequently sleeping less than 7 hours of sleep per night. At baseline, participants were given a wrist actigraph to objectively measure sleep and were asked to record their sleep and wake times in 7-day sleep diaries, along with their food intake.

After baseline assessments, participants were randomly assigned with stratification to the sleep extension group (n = 21) or the control group (n = 21). Participants in the sleep extension group were given a personalized sleep consultation session with the purpose of encouraging participants to increase time in bed by about 1-1.5 hours each night. The control maintained their usual habits.

After one month, researchers found that the sleep extension group increased their time in bed by 55 minutes, sleep period by 47 minutes, and sleep duration by 21 minutes, on average. These increases led the sleep extension group to meet a weekly average sleep duration of the recommended 7-9 hours. These increases in sleep were not observed in the control group. However, participants in the sleep extension group reported a decline in sleep quality. The researchers speculated this might have been due to the adjustment period of spending more time in bed. Participants in the sleep extension group also self-reported lower sugar consumption, which was significantly different from the control group. There was a trend towards a decrease in carbohydrate and fat intake in the sleep extension group as compared to the control group, but this was not significantly different. The researchers found no difference in cardiometabolic risk factors or appetite hormones between the groups from pre- to post-.

These results demonstrate that sleeping longer could be associated with consuming less sugar. However, this study had several limitations, such as using a small sample of predominantly white females and relying on self-reported food records. More research needs to be done in this area using larger randomized controlled trials over a longer duration. For now, the current sleep recommendations are to aim for 7-9 hours of sleep a night.

 

Reference:

  1. Al-Khatib HK, Hall WL, Creedon A, et al. Sleep extension is a feasible lifestyle intervention in free-living adults who are habitually short sleepers: a potential strategy for decreasing intake of free sugars? A randomized controlled pilot study. Am J Clin Nutr. 2018;0:1–11. doi:1093/ajcn/nqx030
By: R. Alex Coots
For scientists, the benefits of nutrition and health research are immediately apparent. It’s easy for us to see how the general public and policymakers alike can benefit from a better understanding of health and nutrition. Few of us would argue that we need less health research or fewer grants, but this is exactly what’s been happening since the NIH budget doubling ended over a decade ago. Decreasing budgets means fewer studies, and fewer studies means less progress on today’s pressing health problems. To help address this problem, I spent a day on Capitol Hill with professors, patients, and other stakeholders to advocate for a more sustainable and predictable funding schedule for health research.
Given the abundance of high quality research institutions in New York, I thought it would be easy to get legislators to support science. How wrong I would be. At best, congressional staff received us with apathy and at worst, hostility. During one particular meeting, an elected representative went so far as to say “All you people want is more and more and more rather than try to make what you have go farther.” And this was said by someone who co-sponsored the 21st Century Cures Act!
What became clear to me during the meetings was that the science profession was not viewed as one that provides answers to today’s most pressing questions; rather, it was viewed as just another (expensive) special interest group. While many scientists do advocate for use of scientific information in the formation of policy, not many of us advocate for the resources we need to carry out our work. Professor Lawrence Goldstein at UCSD has previously advocated for a phone call with each grant written and each grant reviewed. I’d extend this model to include a call with each paper published so that policymakers can hear the scientific progress being made in their district or state. Ensuring that scientific information is used in policy formation is only part of the advocacy battle. We scientists must ensure that our discoveries are limited by our imaginations, not by a lack of grants.
By Allison Dostal, PhD

It’s not a revelation that most Americans would benefit from increased nutrition education and guidance. Newly released data from the Centers for Disease Control and Prevention1 show that 64% of Americans are overweight or obese – a number that’s held steady over the past few decades – and that nearly 40% of us consume less than 1 serving of fruits or vegetables daily. $210 billion is spent annually on obesity-related disease2.

It is known, perhaps intuitively, that physicians trained in nutrition achieve improved health outcomes in patients with obesity-related conditions3. Numerous clinical guidelines recommend that physicians counsel their overweight and obese patients on diet, and yet, fewer than 25% feel that they received adequate training in doing so. As a result, only 1 in 8 medical visits includes a discussion of nutrition4,5. This disconnect in recommendations versus practice is a significant issue in medical education today, and the perennial discussion of how to improve the current state of nutrition education in the medical curriculum continues to increase in relevance in our nation’s obesity crisis.

The Problem

It is recommended that physicians-in-training receive 25 contact hours of nutrition education, including basic nutrition knowledge, assessment, nutrition intervention, and dietary treatment of disease. However, nutrition education in medical schools has continued to fall below this target – and it’s getting worse. A 2012 survey4 found that most medical schools fail to require the recommended amount of nutrition education, with less than 15% of schools providing the 25-hour minimum. The number of hours devoted to nutrition education has dropped substantially since 2004, while the number of schools with no required nutrition education has risen4.

Compounding this issue, many medical training programs provide only basic nutrition background, often buried within a biochemistry or physiology course. While it is undeniably important to highlight the specific actions of vitamins and minerals, this model fails to highlight real-world clinical application of nutrition. Even less time is devoted to developing patient counseling skills. Lastly, the U.S.’s health professional training systems do not provide expertise or incentives to deliver effective counseling on how to achieve and maintain a healthy weight, diet, and physical activity level. This leads to a divide in thinking – a “should” or “want to do” versus “need to” or “have time to do”, and a reduced sense of urgency about implementing changes.

Working Toward a Solution

In addition to a lack of monetary or standard-of-care incentive to increase knowledge dissemination, another primary reason for suboptimal nutrition education is lack of time. This exists both in the amount of time devoted to actual coursework within medical training and for development of a nutrition curriculum within a program. Fortunately, several groups have worked diligently to provide resources that alleviate these barriers. In contrast to many programs that are specific to a particular institution, Nutrition in Medicine6, is a web-based series for students and healthcare professionals, administered through the University of North Carolina at Chapel Hill’s Department of Nutrition. There are over 40 modules ranging from 15 to 60 minutes in length that offer basic nutrition knowledge as well as evidence-based instruction of clinical skills. In addition to providing biochemical, clinical, and epidemiological components and virtual case studies, NIM also offers nutrition tools like pocket notes, nutrient recommendations, quizzes, and YouTube video vignettes. Nearly 75% of U.S. medical schools take advantage of at least one NIM module, and the program has proven to be successful in providing 33% more nutrition education in schools that use NIM versus those that do not.

And the best part? It’s completely free.

Future Directions

Despite the advances made by NIM in improving the dissemination of nutrition knowledge in the medical curriculum, challenges remain. Martin Kohlmeier, NIM’s principal investigator, has acknowledged that building good nutrition education tools is expensive and time consuming, since materials need to be reviewed continuously and updated every 4-5 years. Supporting a web-based tool takes a significant amount of resources, and funding sources are difficult to consistently maintain.

Recently, this cause has been taken up by several prominent health and medicine-focused organizations. A new effort has been launched to teach medical students, physicians, and other allied health professionals how to discuss obesity treatment and prevention options with patients. This initiative is a collaboration between the Bipartisan Policy Center, the Health and Medicine Division of the National Academies of Sciences, the American College of Sports Medicine, and the Alliance for a Healthier Generation. The multi-year project, supported by the Robert Wood Johnson Foundation, will develop “core competencies for obesity prevention, management, and treatment for the health professional training pipeline and identify payment policies that will incentivize the delivery of this care”, as stated in their April 11th press release7. Their goals are for these competencies to be implemented in training programs across the full spectrum of health professionals, and to determine a strategy to reimburse effective counseling for maintaining a healthy weight, diet, and physical activity level. “Training health professionals without a concurrent strategy to reimburse this type of care will not lead to meaningful change. And offering payment without having trained professionals to provide the care also will not result in improve[d] patient care,” the group stated.

This working group, like those involved in the Nutrition in Medicine curriculum, acknowledges that systemic changes to improve nutrition education in medical training will require continuous commitment from a wide range of stakeholders. Details of this initiative have not yet been announced, but those of us involved in education and clinical care certainly look forward to seeing the first steps begin.

Are you a health care professional, student, or educator? What is your experience in teaching or learning nutrition and nutrition counseling skills? I welcome your comments and insight on this issue.

References

1.Nutrition, Physical Activity and Obesity Data, Trends and Maps web site. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity and Obesity, Atlanta, GA, 2015. Available at http://www.cdc.gov/nccdphp/DNPAO/index.html.

2.Cawley J and Meyerhoefer C. The Medical Care Costs of Obesity: An Instrumental Variables Approach. Journal of Health Economics, 31(1): 219-230, 2012.

3.Rosen BS, Maddox PJ, Ray N. A position paper on how cost and quality reforms are changing healthcare in America: focus on nutrition. Journal of Parenteral and Enteral Nutrition 2013;37(6):796–801.

4.Adams, K.M., Kohlmeier, M., & Zeisel, S.H. Nutrition Education in U.S. Medical Schools: Latest Update of a National Survey. Academic Medicine. 2010;85(9): 1537-1542.

5.Early KB, Adams KM, Kohlmeier M. Analysis of Nutrition Education in Osteopathic Medical Schools. Journal of Biomedical Education, vol. 2015, Article ID 376041, 6 pages, 2015. doi:10.1155/2015/376041

6.K. M.Adams, M.Kohlmeier, M. Powell, and S. H. Zeisel, “Nutrition in medicine: nutrition education for medical students and residents. Nutrition in Clinical Practice. 2010;25(5), 471–480. Available at: http://nutritioninmedicine.org/

7.Bipartisan Policy Center. New Effort Launch to Train Health Professionals in Nutrition and Physical Activity. http://bipartisanpolicy.org. 21 Mar. 2016.

By Marion Roche, PhD

At the 2014 Clinton Global Initiative in late September, former President Bill Clinton remarked that a Masaai Warrior has better access to mobile communications today using a small cell phone than he had during his presidency 25 years ago. This access to technology is providing a wealth of opportunities, including in nutrition research and programming. Cell phones are ubiquitous across the African continent and are being used increasingly as an essential part of health community plans: in the area of emergency maternal health, such as when labour stops progressing; for improving supply demands, such as when rural clinics run low on zinc and oral rehydration salts (ORS). The use of cell phones has been at the forefront of the emergence of an entire field of mobile health, known as m-health. One of the most popular uses is probably communications messaging, such as sending regular SMS reminders to parents for growth monitoring visits.

Mobile technologies also offer innovations in global nutrition research. As cell phone use across Africa increases, it becomes easier and easier to train field workers in the use of personal data assistants (PDAs), as people are more familiar with the technology from having their own cell phones. One such example from the Micronutrient Initiative (MI) is the use of PDAs for data collection in our field surveys evaluating a mass media intervention to improve zinc and ORS for the treatment of diarrhea in Senegal. Interviewers carried a PDA with questionnaires loaded onto their device. Text-prompts guided them through the questionnaire, eliminating the need for paper surveys and the logistical complications of storage and transportation that paper surveys add. In the case of our Senegal survey, the PDAs connected to the mobile network daily and sent the interviews to a central server, eliminating the step of manual data entry, as PDAs are configured to send the data directly into the digital database. Anyone who has done data entry can appreciate the extreme benefit of being able to skip this time-consuming and high-risk-for-errors step. Further, the study supervisor can check for concerns in data quality from multiple study sites on a daily basis and follow up with interviewers the next day, potentially increasing overall data quality. And just as important, the issue of lost or damaged paper questionnaires is greatly reduced.

Using PDAs for field surveys opens up other new opportunities, such as incorporating visual media into questionnaires. We were able to provide caregivers in our Senegal zinc and ORS study with pictures of the different brands of products available, giving programmers important insights. The use of images can also be helpful in surveys with dietary recalls, although this option would require preparation of uploading photos and knowing the foods and supplements available to the targeted audience in advance. After a media campaign, we could include images from television spots or radio segments to see if parents recall the ads.

Global Positioning System (GPS) is now offered with some PDAs, which can help in monitoring data quality, survey implementation, and new ways for interpreting data. For example, with the Senegal project, we have the GPS coordinates for households and a visual map of clusters, or hot spots, for diarrhea infections, enabling us to prioritize these areas for intervention. We were also able to ask families about radio stations they listened to and create a map of radio stations reaching the communities in order to develop a national mass media campaign using local radio stations. With traditional surveys it could be months before this type of information would be available.

Despite the advances in using PDAs for data gathering, there are downsides, the biggest being initial purchase costs, related software, as well as having the training and expertise to support surveys in-country. Other challenges are short battery life, theft, connectivity issues, and, in some cases, the need for accompanying paper consent forms. At MI we are fortunate to work with Canadian partner Health Bridge whose expertise and equipment support our local partners and the MI office in Senegal. Innovations in enabling access to these new technologies may be the next challenge in m-health for nutrition surveys, as we work towards systems that provide greater access to larger segments of populations in low to middle income countries.