Doctor David B. Allison is the current dean, distinguished professor, and provost professor at the Indiana University School of Public Health-Bloomington. Prior to Indiana University, Allison was a distinguished professor, Quetelet Endowed Professor, and director of the NIH-funded Nutrition Obesity Research Center (NORC) at the University of Alabama at Birmingham (UAB). Allison was appointed director of the NORC in 2003 and served until 2017. Allison has published more than 500 scientific papers with research interests including obesity and nutrition, quantitative genetics, clinical trials, statistical and research methodology, and research rigor and integrity.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NORCs are “intended to integrate, coordinate, and foster interdisciplinary basic, clinical, translational, and public health research by a group of established investigators actively conducting programs of important, high-quality research that is related to research specific to NIDDK’s mission.”

There are currently twelve university-based NORCs across the United States from New York to Washington State. These centers are funded by P30 Center Core Grants from the NIDDK to bring together investigators who are conducting research in nutrition and obesity and improve the quality of research by promoting multidisciplinary work and sharing access to specialized technical resources and expertise. These centers allow for cost-effective collaboration between groups of investigators at the same institution. The NORC at UAB currently has 159 investigators from 58 different academic units – a manifestation of the center’s multidisciplinary approach.

Allison’s 14-year appointment as director of UAB’s NORC makes him an ideal individual to speak with about the successes of the initiative since its inception in 1999. Allison was gracious enough to answer several questions about his tenure as director and about NORCs more broadly.

What role do you see NORCs playing on university campuses?

NORCs are enormously helpful, and it is valuable to consider them in a historical context. The first NORC – before they were even called NORCs – was the New York Obesity Research Center at Columbia University and, at the time, Rockefeller University. It was the first and for many years only federally funded obesity research center in the United States. The NIDDK subsequently decided to call all the clinical nutrition research units and obesity nutrition research centers “NORCs,” and there are now twelve under this designation.

The New York center is where I started my career as an obesity researcher during my second postdoc. It was a lot of fun there. The NY Obesity Research Center was the mecca of obesity research. If you were an obesity researcher, and if you wanted to get trained, you knew where the mecca was. If you wanted to make a pilgrimage, you could see what the great leaders of the field were doing. You could go there and meet esteemed individuals such as Ted VanItallie, Xavier Pi-Sunyer, and Steven Heymsfield.

You sort of knew where the leadership was – where the intelligentsia and cognoscenti were. There were certainly other places in the world that were powerhouses in obesity, but in the United States, the NY Obesity Research Center served as a galvanizing force. It also served as a great training ground at the time – and NORCs still do. It is one of the things that makes NORCs special: they are multidisciplinary, and they are focused on a topic.

What you sometimes see in the field of obesity, which is probably true in other fields as well, is that there are a lot of instances of people making mistakes that I refer to as “errors in interdisciplinarity.” This is an error which one makes because one is completely unaware of something that would be basic and fundamental to someone in another discipline – but you as a member of a different discipline aren’t aware of it.

A simple example would be if you are a social scientist and you know that physical activity matters for obesity, and you make an assessment that some program will have an important effect, but you don’t know anything about body mass or energetics. You then project the amount of weight change that could occur because of the physical activity intervention without understanding the physics, the mechanics, or the energetics. This is an error of interdisciplinarity.  We see these things regularly.

When I was “growing up” in the NY Obesity Research Center, these kinds of things would become the fodder of your education as a young person. So if you piped up and raised your hand in a seminar and said, “What about this?” it may reveal that you didn’t understand a basic concept in statistics, psychology, physiology, or anatomy. Then the more senior people around, who were experts in those things, would say to you, “Come on over here, kid, let’s explain to you that’s not how that works.” You got it drilled into your head, an emphasis of interdisciplinarity – the idea of real expertise – and avoiding these simplistic mistakes that you still see so often now in people who are focused on obesity research. That is one very valuable part of it: bringing together an interdisciplinary cadre of experts on the topic who then educate young people to be an expert in a topic, and not just get caught up in their own discipline.

The second thing that is extremely valuable is the idea of the NORC as provocateurs of people’s interests. The total amount of money in the NORCs per se is not much – around $750k/year in direct costs – not much bigger than one or two R01s. What is important is not the total cash value, but the way the value is delivered through a leader on campus, who then uses the funds as a lever, at the right points to provoke activity, and provoke interests.

Years ago, early in the NORC’s history at UAB, it became clear to me that using more invertebrate models for obesity was important, that genomics was upon us, and that we should have people working with Drosophila and C. elegans. I was able to use different pieces of the NORC to provoke that. For example, I would bring in speakers through our seminar series who worked on those topics. We had funding for pilot grants that could be used on that research. There were extra discretionary funds from institutional matching, so I could use those funds to recruit some younger people to work on these topics. All those things came together so that people were writing and getting R01s to do research involving those organisms.

There are other things that are important for the NORC in terms of sense of identity.  People are excited to be at an NORC because they feel that they are at one of “the” places. The dollar amount of the NORC isn’t that great, but the prestige value is high. It serves to create an identity to get people excited – to pull them together to work together on things. Those are some of the big values of the NORCs today.

You were director of the NORC at the University of Alabama at Birmingham for nearly 15 years. How have you seen the effect of NORCs change over that time?

I think we have seen a couple of changes. In general, science has changed, and the NORC science has changed with it. Science has become more molecular, more genetic, and the NORCs keep up with the trends of general science. Other things I have seen in NORCs is this idea of leveraging the amount of money. Not only is the amount of money provided by the direct costs of the NORC not large, especially compared to diabetes centers, cancer centers, and other NIH centers that receive much more than NORCs, but it’s been flatlined for over 20 years. If you compared the NORC funds in real dollars to the dollars from 20 years ago, the current funds are much smaller.

NORCs have become these engines – at their best – where creative leaders use the P30 grants as the nucleating site around which to build other stuff. You go to your institution and get a match in funds, and then you get some T32 grants. You say, “Isn’t this great we have an NORC, so we can do great training. Please give us a postdoctoral and predoctoral T32 in obesity, and then why don’t you give us an R5 to do a national short course in obesity?” … You keep adding those things on. We at UAB were very strong on that. Many other institutions are as well, and that is one way you have seen the NORCs change. They have become these multi-infrastructure grant organizations.

When speaking with other NORC directors and center administrators, what are some of the advances and successes that have stood out to you?

I think probably more than anything, the successes and advances that I hear the NORC directors take the greatest pride in is the young people who they help get started, and that is especially true for those NORCs that go on to get T32s, which many have. How I got my own start was on a T32 while in New York. That is also how I learned to write T32s, by being thrown into it by my old boss at the NORC. He said, “Here’s my old folder. I’m going on a trip out of the country. I will be back after this thing is due. Good luck,” and I said “…okay,” and so I learned how to write a T32 grant.

I think when people are successful in getting those T32 grants, as well as in getting young people involved, however they do it, bringing new people into the field, and helping those new people achieve, it is a great success. You can look at many of us and say that we are products of the NORC systems themselves. Myself, Doctors Dympna Gallagher, Tim Nagy, Barbara Gower, Michael Goran, and many others, are all the products of these centers, brought in as postdocs at the beginning of a center. Many who are NORC directors now got their start there.

How do NORCs help cultivate the future generation of nutrition and obesity researchers?

To reiterate, the interdisciplinarity: training people so they are not just a public health person that says, “Yeah I get it, people, they eat too much and exercise too little, what else do I need to know about obesity. Now I just need to talk about the policies that will make people eat less and exercise more.” Well, maybe it would be good to know a little more than that. NORCs bring up people with a more robust knowledge of this. The NORCs also draw people into the field, give them a sense of identity and belonging and an enthusiasm for being in the field.

You have been critical of the rigor at which obesity and nutrition research is performed. Do you think that NORCs have been able to increase the quality of research in the field?

I think that NORCs do increase the quality of research in the field, and they lead by example. I am critical of the rigor and quality of the research everywhere, including in my own research. That is important for us to do as scientists – to be critical of the rigor and the quality of research – and to make it better. I think there are particular concerns raised in the field of obesity, and some of those concerns in my mind came out in the mid-90s when obesity began to be seen as a public health crisis.

Instead of obesity research being driven to a greater extent by people who were fully involved in it for a long time, and involved with others in getting this interdisciplinary background, it became more that anybody felt that they can jump in. Any economist, any public health official, jumped in with zealous passion, which much of the time wasn’t matched with rigorous background knowledge. This has led to some of the more questionable research we have seen. It’s not everything, but just one factor. NORCs are helping by providing training for people, by putting out good research, and by leading by example.

What are some fond memories from your time at UABs NORC

Well, pulling together on things in general. Part of what makes a great center great is people working together as a center. In fact, one of the things that attracted me to come down to UAB was in fact its centeredness. I had other offers before heading to UAB, and some were at institutions that were more attractive in some ways, but what I liked about UAB and the NORC was the feeling that this was a group of people that worked together, and only a slight exaggeration, but it was a sense of a family. I really liked that. To me, a lot of my fondest memories were pulling together with Tim Nagy, Barbara Gower, José Fernández, Tim Garvey, the late Roland Weinsier, Stephen Barnes, Steve Austad, Kevin Fontaine, Julie Locher, Gary Hunter, and I am sure I’ve missed many important people, but the ability to pull together through tough challenges, working hard, overcoming obstacles – doing things together which none of us could have done alone.

 

This is part two of a two-part interview with Dr. David Allison.

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