Biomedical Base
Harvard Clinical Nutrition Research Center
Biomedical Base
AIDS
Following are the primary investigators of this theme and a brief discussion of their work.
Dr. Grinspoon has had a meteoric rise as clinical investigator in the HNCRC. He has received a P/F grant in each of the last two funding periods which have both resulted in RO1 funding. He has also trained two junior faculty (Drs. Hadigan and Huang) each of whom have gotten K23 awards and P/F funding leading to R-21 awards. With the death of Dr. Young last year, Dr. Grinspoon has been selected as the new Co-Principal Investigator to replace him in the renewal application. His principal responsibilities will be to facilitate clinical nutrition research. Dr. Grinspoon is currently an RO1 investigator, studying the effects of androgen administration on nutritional status, body composition and functional capacity in women with AIDS wasting. This work has provided P/F and R21 funding for Colleen Hadigan. Related research areas include the newly discovered lipodystrophy syndrome in HIV, characterized by increased visceral adiposity and insulin resistance. Dr. Grinspoon is also involved in the research to delineate the physiological regulation of leptin in states of undernutrition. In this regard, he has published on leptin levels in anorexia nervosa and in response to acute fasting and refeeding. Recent data from his group suggest that leptin levels are low in hypothalamic amenorrhea, independent of weight and body fat and may be related to fat intake. The work on leptin was funded, in part, through P/F funding from the HCNRC. A final investigative focus remains the effects of insulin-like growth factor-I (IGF-1) on bone turnover and density in anorexia nervosa. This work provided the basis for P/F study with Dr. Jeannie Huang and has lead to R-21 funding. She is currently a junior faculty member at the University of California in San Diego and a consultant in the HCNRC renewal. Most recently he has extensively studied the mechanism of lypodystrophy in HIV patients. These studies have resulted in two RO1 funded projects.
Wafai Fawzi
Dr. Fawzi joins the HCNRC renewal as a new Investigator. He brings an extensive background in nutritional epidemiology and international health, particularly the transmission of HIV from the nursing mother to her newborn in Tanzania. His research is as follows: over the past 12 years he has focused his efforts on establishing a regional center of excellence for the study of nutrition and disease prevention in collaboration with Muhimbili University College of Health Sciences in Dar es Salaam, Tanzania. He undertook research and public health practice activities in most district hospitals and health centers, and in the larger community in Dar es Salaam. While nutrition is a central focus to all that he does, it is not possible to pursue this agenda in isolation of the broader public health needs affecting women and children in Tanzania. 1) Research on Nutrition and Pregnancy Outcomes: This group conducted a series of clinical trials to examine the efficacy of other micronutrients supplementation on pregnancy outcomes among HIV-positive and HIV-negative women. In addition to examining the efficacy of these supplements, other aspects of nutritional status are being examined. Data on dietary intake of mothers and children are being collected using food frequency questionnaires and 24 hour recalls, and infant feeding practices and anthropometric measurements are documented regularly. 2) Research on Nutrition and Child Health: This research focuses on the role of nutrition in reducing mortality, incidence and severity of morbidity including diarrhea and respiratory infections, and in improving growth. The efficacy of direct micronutrient supplementation of children is being examined in randomized trials. In addition, they are examining the effect of supplementing mothers who are breastfeeding on various maternal and child health outcomes and on breast milk quality. The latter questions are examined among HIV-positive and HIV-negative women and children who participated in the prenatal trials mentioned above. 3) Research on Nutrition and HIV/AIDS: Dr. Fawzi examines the nutritional and metabolic consequences of HIV infection using data from longitudinal studies of both HIV-positive and HIV-negative populations.
Christopher Duggan
Dr. Duggan joins the HCNRC renewal as a new Investigator after receiving P/F funding as an Associate Investigator in the previous granting period and recently having a RO1 funded. His major research interests include 1) the nutritional management of acute and persistent diarrhea, 2) micronutrient trials in developing countries, and 3) general aspects of energy and protein metabolism in catabolism. In this country, he has led studies evaluating the formulation and effectiveness of oral dehydration solutions for the treatment of acute diarrhea. In one randomized community-based trial, he demonstrated that distribution of ORS to families at the time of their visit for acute diarrhea resulted in improved care and fewer unscheduled visits to urgent care centers for further management. His work in ORS research has lead to participation in international (WHO) and national (CDC) policy making groups on the topic of diarrheal diseases, as well as an ongoing consultant’s relationship with the Applied Research for Child Health Project. In both developing and industrialized countries, he has completed studies on the micronutrient status of children, including those with cystic fibrosis, malaria, undernutrition, and acute and chronic diarrhea. In several of studies in the US, he is applying state of the art nutritional assessment techniques (e.g., stable isotopes, indirect calorimetry, body composition methodologies) to patients with a variety of catabolic illnesses, including HIV/AIDS, inflammatory bowel disease, short bowel syndrome and cancer. He is co-investigator in two NIH-funded trials of micronutrient supplementation among women and infants in Dar es Salaam, Tanzania and was recently funded for similar studies.
Eduardo Villamor
Dr. Villamor joins the HCNRC renewal as a new Investigator. He joined the faculty in the Department of Nutrition at the HSPH in 2004 after completing a DrPH and a postdoctoral fellowship at the HSPH. As a medical doctor trained in Columbia he has had a longstanding interest in maternal transmission of HIV to neonates and the role of protective nutrients in its prevention. As newly funded RO1 investigator he joins the Nutrition and AIDS working group. His specific research interests are as follows: 1) Nutrition and infection: How the nutritional status of individuals influences their risk and response to infectious diseases, and how episodes of infection alter the nutritional status in the short and long term. Current areas of research include: a) the effect of nutritional interventions on mother-to-child transmission of HIV through viral shedding in breast milk, and b) the magnitude and consequences of protein-energy malnutrition associated with infections that are highly prevalent (HIV, tuberculosis, malaria) in countries with atypical patterns of development. 2) Maternal and child nutrition: Current research topics are: a) effect of nutritional interventions to improve the outcome of pregnancy, b) anthropometric and body composition changes during pregnancy and their impact on gestational outcomes, and c) how micronutrients modulate the impact of infections on child growth. 3) Auxological Epidemiology and Anthropometric History: The use of anthropometric indicators to assess the impact of general political, social, and economic historical processes on the standard of living of populations.