Human Nutrition: a Brief Overview

Nutrition is central to treatment and prevention of many human diseases.  This division participates in investigator-initiated research, teaching and service, and provides a focus for human nutrition within this academic medical center. 

The division occupies the third floor of Ewing Hall, where it provides ~4,000 square feet of laboratory space, specialized equipment and faculty offices. 

Faculty and staff.  Eight nutrition faculty members (five in the tenure track) have primary appointments in PMCH and have offices within the division.  Seven faculty with primary appointments in other departments have cross appointments in PMCH through the division.  In the past 15 years, 3 tenure track faculty have left or retired (Wallwork, Ganther, Alcock).  Two tenure track faculty transferred to Human Nutrition from another division and one was recruited.  Over the same time period four nontenure track faculty were appointed and have left (Lynn, Vadhanavikit, Goeger, Egger) and two were appointed and are still active. 

Faculty with primary appointments:

Karl E. Anderson, M.D., Professor & Division Director

Richard M. Carroll, Ph.D., Associate Professor

Chul Lee, Ph.D., Associate Professor

Lee-Jane Lu, Ph.D., Professor

Wolfgang Maret, Ph.D., Associate Professor

V.M. Sadagopa Ramanujam, Ph.D., Associate Professor

Harold H. Sandstead, M.D., Professor

Faculty with cross appointments:

Christopher J. Frederickson, Ph.D., Adjunct Professor, Anatomy & Neurosciences

C. Lawrence Kien, M.D., Professor, Pediatrics

Gordon L. Klein, M.D., Professor, Pediatrics

Phillip G. Lee, Ph.D., Associate Professor, Human Biological Chemistry & Genetics

Kimberlee M. Matalon, Ph.D., Clinical Associate Professor, Pediatrics

Karen E.M. Szauter, M.D., Assistant Professor, Internal Medicine

Robert, R. Wolfe, Ph.D., Professor, Surgery

Staff currently includes an administrative secretary supported by the department and a senior secretary supported jointly by the division and the department.  Ten research staff (research assistants and study coordinators) are supported by grants or other external funding.  Three of these are supported by Drs. Anderson and Lee and seven by Dr. Lu.  Dr. Maret is currently seeking two research laboratory workers.  A graduate student (Yafei Huang) is pursuing dissertation research with Dr. Lu.  Other graduate education activities are described below. 

Medical School Teaching. Drs. Carroll and Ramanujam teach extensively in the Integrated Medical Curriculum (IMC) as lecturers and small group facilitators, especially in the GI-Nutrition course.  Others (Anderson, Lee, Lu and Sandstead) contribute to this effort.  Dr. Anderson served as co-director of the GI-Nutrition course for 3 years.  Drs. Carroll and Ramanujam serve on course committees and on committees that review student performance in the IMC.  Dr. Anderson teaches students and residents at the bedside as an attending in Internal Medicine for several months per year. 

Graduate School Teaching and Mentoring.  All nutrition faculty have appointments in the graduate school and contribute to teaching graduate students.  The Curriculum in Human Nutrition (Richard M. Carroll, Ph.D., Coordinator) has graduated five students since 1996 (William Durham, Dec. 2000; Cathy Weikart-Yeckel; Dec. 2001; Wenjun Martini, Dec. 1998; Bettina Mittendorfer, May 1999; Steven Sparks, Aug. 1996), all of whom did their dissertation with Dr. Wolfe.  A current student (Carwyn Sharp) is also doing his dissertation under Dr. Wolfe, and another (David Barr) and also plans to do so.  Yafei Huang is doing dissertation research with Dr. Lu, and a student entering the BBSC this fall plans to work with Dr. Maret.  The faculty offer a course in Basic and Applied Nutrition, which is required for students in the Human Nutrition Curriculum.  They also contribute to a joint Research Design course offered for students in Human Nutrition, Clinical Science and Environmental Toxicology. 

The Clinical Science Program (director Karl E. Anderson, M.D.), is partially supported by a K30 grant.  This program provides graduate training (Ph.D. or M.S.) for M.D.s and others with a career interest in clinical research.  Since its inception in 2000 the Program has grown to an enrollment of 16, with two graduates.  The Herzog Foundation has provided an endowment to partially support students in this program.  This was among the first graduate programs in the U.S. to offer a Ph.D. degree for clinical investigators.  Dr. Anderson also directs the course Clinical Research: Tools and Techniques. A number of nutrition and other PMCH faculty contribute to these programs. 

Post-doctoral training has been provided to a number of junior scientists.  For example, Katsuhiko Yokoi, MD trained with Dr. Sandstead and is now a professor and department head at a medical school in Japan. 

Funded research.  External grants awarded to primary nutrition faculty that were active since 1998 totaled $12.4M (direct costs $8.9M).  Additional research funding has been brought in by Drs. Ramanujam, Serfass and Lee through the Nutrition Assessment Laboratory and the Porphyria Laboratory, which operate as a service center for research collaborations as well as service. 

Research areas.  Research, which involves human subjects and laboratory models, has focused primarily on essential trace metals, soy and isoflavones for prevention of breast cancer, and disorders of heme metabolism.  Faculty are recognized internationally for expertise in these areas.  Division research is inter-disciplinary and commonly involves human subjects.  The PMCH department has for a number of years been the first or second major user of the General Clinical Research Center, due mostly to research conducted by this division. 

Trace metals.  Zinc nutriture was found to influence cognition of normal young women and Mexican-American children in the US and of children in China, in randomized, double blind controlled studies (Sandstead, Ramanujam and others).  Zinc status was assessed in premenopausal women by zinc kinetic studies using stable zinc isotopes and inductively coupled plasma mass spectroscopy (ICPMS).  Neuropsychologic testing was in collaboration with James Penland, Ph.D. at the USDA Agricultural Research Service Human Nutrition Research Center in Grand Forks, North Dakota.  The findings have implications for millions of children world wide who subsist on diets with limited bioavailable zinc, and for women in and children in the US who consume diets low in both zinc and iron. 

Serfass is recognized internationally for his expertise in ICPMS and its application to biological effects of trace metals.  He has studied iron absorption in human infants in collaboration with investigators in Iowa.  He is currently characterizing, with NIH support, a novel iron binding protein he discovered in human milk. 

Maret, a recent addition to the faculty from Harvard Medical School, studies the role of metallothionin in the cellular uptake, distribution and storage of zinc, and how it plays a role in the regulatory functions of zinc and the control of the cellular redox state.  His work is funded by NIH and also in part by a collaboration with Dr. Fredrickson, of Neurobiotex in Galveston. 

Ramanujam and Alcock have studied toxic effects of metals, including lead and mercury.  They studied levels of mercury in pregnant women eating seafood in Galveston and surrounding communities, and levels of metals in breast milk.  In addition, they examined levels of multiple metals in porpoises in Galveston Bay.  Ramanujam studied amounts of uranium, thorium and lead in multiple soil samples from a uranium mining area near San Antonio.  Ramanjam has studied the inhalation toxicity of benzene and metabolism of soy isoflavones. He is currently studying mercury in teeth of children with autism.  These studies were funded through external grants, UTMB intramural grants, collaborations, or through the service center. 

Soy feeding and breast cancer risk.  Lu and colleagues have been studying the effects of soy feeding in women for more than 10 years, with funding from NIH, US Army, and the American Institute for Cancer Research.  She found that soy, when fed as a replacement for 15% of energy intake, lowers ovarian hormone levels in women by 20 to 45%.  This degree of reduction is similar to hormonal differences between populations of women with high and low risks for breast cancer. Her result is applicable to 79% of US population and has significant public health implication for breast cancer prevention. She also found that soy isoflavones modulate tumor necrosis factor-alpha, an inflammatory cytokine, and may modulate the immune system. Two ongoing randomized double-blind placebo controlled clinical trials aims to determine if soy affects breast density and bone mineral density, and will assess whether effects are mediated by isoflavones or soy proteins.  Yafei Huang is working as a graduate student with Dr. Lu to develop protein markers in serum and nipple aspirates that may be useful for early breast cancer detection and prevention, and is supported by a pre-doctoral fellowship from the US Army. 

Human porphyrias.  These diverse conditions are due to specific enzyme deficiencies and are affected by nutritional factors and drugs.  Anderson, Lee and colleagues comprise the only major research group to focus on new approaches to treatment and prevention, and factors that influence susceptibility, such as vitamin C deficiency.  Treatments studied have included GnRH analogues to prevent premenstrual exacerbations of acute porphyrias, erythropoietin for porphyria cutanea tarda (PCT) when associated with end stage renal disease, intravenous heme and tin mesoporphyrin for treatment of acute porphyrias, and hydroxychloroquine for treatment of PCT.  The group is currently studying treatment with a recombinant human enzyme to replace the deficient enzyme in acute intermittent porphyria.  New treatment studies, clinical consultation and diagnostic testing available through The Porphyrin Laboratory have made UTMB a major referral center for patients with these uncommon and complex disorders.  Better delivery of advice to patients is being studied using telemedicine. 

Service.  Faculty have participated in educational activities in the community.  This has included mentoring of high school students and teachers during research experiences at UTMB and judging in science fairs.  Participation in the Summer Undergraduate Research Program (SURP) has led to the recruitment of graduate students to UTMB.  The Porphyrin Laboratory is a major resource in the US and internationally for diagnosis and assessment of human porphyrias.  The laboratory is part of the UTMB clinical laboratories, and is partially supported by research grants, donations and fees charged for testing.  The Nutrition Assessment Laboratory has provided reliable testing for heavy metals (e.g. lead, mercury) in human samples, soil and other samples. Faculty also actively participated in grants review for NIH, DOD, FDA, VA, private foundations and others.