Jeffrey Bland, PhD reflects on his 1983 edited book Medical Applications of Clinical Nutrition, recounting contributors and early ideas in nutritional medicine (e.g., exercise physiology, glycemic responses, lipoproteins, orthomolecular psychiatry, dietary fiber, clinical nutrition practice). He connects how ideas originate, spread, and become clinically impactful and frames this history as guidance for future breakthroughs that could transform disease-care into healthcare.
Chapters
I'd like to take you back to, I know, Ancient History, 1983. And the reason I'd like to go back to 83 is that I had a discussion just last week with one of my colleagues who has traveled this journey with me in this nutritional medicine space for the last 30 years. And he reminded me that one of the things that got him into the field when he was a medical student was a book that he was introduced to that was published in 1983. And it happened to be a book written and edited by me entitled Medical Applications of Clinical Nutrition. And as he got talking about the book and what impact it made on him, I got thinking about all sorts of things, about what is information, how does it travel, how does it get sticky, where does it start? Who do we give attribution to? How do cultural evolutions change? I mean, all sorts of questions came to my mind, made a decision, maybe I should go back and relook at this book just to see what was in it. A lot of time has gone by and I have to say I haven't looked at this book in a long time. And when I looked at it I was truly blown away. I was blown away not because I was the editor author, but because the sub authors. This was a compilation of contributions from a variety of people that I asked if they would submit chapters that were, I felt, experts in their field in 1983. And as I look at this list of individuals that assembled to write this book, I really was amazed at how things change but don't change. So let me read some names to you that are contributors. William McArdle. William McArdle is in the exercise science and sports medicine area, considered one of the founding individuals to really look at the American Society of Sports Medicine. Some of the scientific studies that relate to diet, nutrition and sports performance. And actually one of the first people to really start talking about the mitochondrion in exercise physiology. Next was Shelton Reiser. Shelton Reiser was at the USDA at the time, in 1980, in the 80s and was involved with the early stage work on carbohydrates, simple versus complex carbohydrate and the glycemic index. This is pre really the formulation of the glycemic index concept, but talking about the different glycemic response to different carbohydrate sources. Next is Herb NATO, who was at Mayo at the time and was extraordinary in his early development of the understanding of lipoproteins in the vascular wall biology and atherogenesis of the diet and how the relationships of some of these subparticles of of the lipoproteins could play roles in the atherosclerotic process. Remind this is of early 80s. Next is Abram Hoffer, obviously orthomolecular psychiatrist. The foundation of this whole concept of taking Linus Pauling's concept and applying it over into psychiatry. His organic chemistry PhD served him well to really look at these molecules that were related to things like niacin and pyridoxine and their relationship to neurochemistry. Early on Raymond Shamburger and his good close colleague at the Cleveland Clinic who were involved with the formulation of diet and behavior in children looking at B vitamins and the role to undernutrition, not nutrition deficiency, but undernutrition and the relationship to child's behavior, iq, learning abilities and so forth. Very pioneering work. And then of course Dennis Burkitt, arguably the father of the dietary fiber hypothesis. A person that I'd had the pleasure of having as a roommate at a meeting actually that I had attended a couple of years previous to this book and got to know him and his pioneering work as a public health service physician in Africa and really making this whole discovery about fiber and digestive disorders. So as I look back and think about this that I'm reminded that in this book there was one other author, an author that's really one of the first people that I collaborated with in the medical side was really starting to see how these things worked in clinical practice medical applications of clinical nutrition. That was Dr. Scott Rigdon who at the time was in upstate Illinois agricultural area and was very actively involved in treating a wide variety of individuals in this farming community using nutrition and lifestyle intervention. Scott going on from there to have over four decades of contribution later moving to Scottsdale, Arizona. So this book to me is a reflection of how ideas evolve, how they get transferred, how they become sticky, how we take ideas that are germinating up and outly translate them into clinical benefit for individuals in need. It's really been fun to kind of go back and reevaluate, but also to look forward and saying what are the ideas that we're seeing today germinate up that will become the next breakthroughs over the next 20 or 30 years that really transform healthcare from a disease care model into a healthcare model. Be assured we're going to continue to be on that subject.
