What's Cooking in Nutrition
Anthony Hollenberg, M.D., remembers the day he made his first research breakthrough. “It was at just the beginning of molecular endocrinology,” the chief of the Division of Endocrinology, Diabetes, and Metabolism at Beth Israel Deaconess Medical Center recalls. “And I was trying to clone gonadotropin genes as part of my senior thesis.” After painstaking efforts to comb through thousands of DNA molecules for evidence of a clone, the Harvard College undergraduate spotted two. “I actually took the film and framed it, and I put it up in my dorm room,” he says of the achievement that sparked his interest in the field and laid the foundation for future basic research.
Now, with a 19-year career in endocrinology at BIDMC culminating as chief of a division with an illustrious history and nationwide reputation for pioneering research, Hollenberg spreads a wide net. Any given day might find him taking care of patients with thyroid conditions, conducting his own basic research to potentially improve care for all patients, and educating the next generation of physician—researchers in translational medicine. “Endocrinology is great because clinically it is intellectually demanding but not as procedure-focused, so you can practice clinical endocrinology while at the same time you can do research and teach,” he says.
Hollenberg has seen tremendous changes in the field since he first started cloning genes, the greatest of which is a better understanding of the processes that lead to human endocrine disease. Researchers have started to comprehend the mechanisms underlying disorders such as diabetes, obesity, and thyroid disease. “The growth of molecular pathophysiology has really allowed us to define the cellular basis for individual disease and to create better customized therapies — although, not as perfect as we would like,” Hollenberg says. “The other thing that has been pretty clear is that we have really seen the progression of diabetes and obesity from a static state to an epidemic in the last 20 years.”
More than one third of the adult population in the United States is obese, and 25.8 million people have diabetes, which puts the Division of Endocrinology, Diabetes, and Metabolism on the forefront of health care today. “Unlike some endocrine divisions in Boston that have many separate focuses, we are a pretty unified division with a concerted research focus in obesity, diabetes, and metabolism that is really unparalleled,” he says. “The clinical care we put forward is outstanding, and our relationship with the Joslin Diabetes Center makes the breadth of care that we can deliver even greater.”
As obesity continues to spread among the population, researchers, including Hollenberg, are searching for new ways to target and treat the problem. In addition to seeing patients, he is investigating the cellular basis of thyroid hormone and how it influences the way we feel, the way we eat, and the way we gain and lose weight to ultimately uncover better therapies for patients who struggle with weight loss or high cholesterol. “It is a hugely important health problem,” he says. “Obesity influences cancer, heart disease, and diabetes. It is a huge risk factor for other diseases, such as stroke, and osteoarthritis. If we can figure out ways to get people to live healthier lives and find new ways to treat obesity, we would have a healthier population and downstream much less disease.”
In response to the growing epidemic and in an effort to build on the assets of the division, BIDMC is establishing a new Center for Nutrition and Metabolism, which Hollenberg will co-direct alongside colleague Eleftheria Maratos-Flier, M.D. BIDMC recently selected the new endeavor as a strategic priority for philanthropy. Initial plans to coordinate and launch the center’s activities are underway. “We need to have a clinical nutrition and obesity center that integrates clinical care with new research discoveries, which we don’t have currently,” Hollenberg says. “We have the strongest research in the field already; we need to have the best clinical care program that complements that strength.”
The first step toward that goal is to focus on the nutritional health of patients and employees at the medical center by introducing intelligent food programs, providing healthier alternatives in the workplace and at home, and raising overall awareness in the community. “We know that exercise won’t do it alone,” says Hollenberg, who plays basketball twice a week and touch football on Saturdays, and runs when he can. “It makes you feel great, but it’s not particularly effective in isolation for losing weight. You can only burn 300, 400 calories in one hour on the treadmill, which is only equivalent to the snack you might eat afterwards.” He notes that putting the emphasis on eating the right foods in combination with physical activity has much more of an impact. The Center for Nutrition and Metabolism will concentrate on supporting these kinds of nutrition-based efforts and helping patients better understand their health and the possibilities for improving it. The goal is to expand the division’s current clinical enterprise, which is already growing 10 to 15 percent each year. The center also aims to build on BIDMC’s nationally recognized research program in this area to form a translational research initiative that would take the discoveries from the bench directly to the patient in the clinic.
The value of translational medicine is not lost on Hollenberg. For the last eight years, as the co-director of the Clinical Investigator Training Program (CITP), he has invested a significant amount of his time in training future physician—researchers from a wide range of disciplines in the principles of translational medicine. Founded at BIDMC and a Harvard-wide master’s program, CITP provides outstanding physicians who want to do early-stage human research with the tools and support to translate their discoveries into new treatments for human disease. Pfizer, Inc. (whose support established CITP in 1993) and Merck & Co. have funded the innovative program, which has graduated 180 translational investigators and counting. Most recently Vertex has also joined as a supporter of the program.
Despite the obvious value of all Hollenberg has on his plate, he recognizes that resources are getting spread thin. “It is getting tougher and tougher to keep all of these programs going,” he says. “That’s the only thing I worry about all the time. How are we going to keep each of these things funded? That is where philanthropy comes in.” He notes that philanthropy plays an equally important role in maintaining initiatives like CITP and getting new projects like the Center for Nutrition and Metabolism up and running. And with his fondness for the multidisciplinary, Hollenberg has a meaningful funding option for any potential donor. “There is nothing like seeing something in your own lab that has never been seen before,” he says. “There is nothing like treating a patient and having it go well. There is nothing like mentoring or being with a student who succeeds. And there is nothing like being head of a division and seeing faculty thrive.”