President’s Nutrition-a

Address, glance

1 992: The American Society backward, a look ahead3

L Bierman

Edwin

of us as members

areas,

it is interesting

had make

some

The

society

came

was

from

and

officially

Dr Robert

to see what

our

president,

as your

has

Its creation

outset,

the American

corporated charter

it was

Institute

decided

conceived

members,

and

nursed

would

be

a brief

obituary

that

rather (AIN),

The

were active in Table 1.

than

compete

with

ASCN

would

be in-

society

MDs

that

started

involved,

with in one

69 way

after

three

absences.

That

rec-

fourfold (Table of undergraduate

and

nutrition

education

in the role

and disease. It is interesting that have assumed that, as a society clinical

nutrition,

ever, it is clear was recognized 32 y of our

research

existence.

in

nutrition,

human

second to present

and

the list because I would devoted to research in

would

head

the list.

our

annual

aim

was to provide

and

discuss

meeting

their

has

How-

Journal and you

ofClinical all know

Nutrition this has

from

or journals and, as by making

medicine.

The fourth objective now reads, “To promote of nutrition 726

research

in-

on Medical/Dental the Committee

on Subspecialty

with

AIN,

including

Public

will

none

of the

original

objectives

on

Training, Affairs

that

note

and

the U.S.

and

this has been one to increase research

Department

Let me pursue First,

addresses

and enhancing the research environment Yet it is certainly a de facto objective.

I’ll look

for clinical During my

of the most active issues, that support by a variety of mech-

anisms from the major government in clinical nutrition, the National

agencies Institutes

supporting of Health

research (NIH),

of Agriculture.

these

objectives

and

at undergraduate

and

see where

graduate

we are in I 992.

education

in human

nutrition. Despite

the

directly

fact

that

6 of the

to diet,

related

10 leading

1 5 y ago,

only

causes

of death

are

of the

125

one-quarter

or so medical schools required students to take a course in nutrition. The past decade witnessed an intensive effort to improve tees,

the

and

Elaine

has

including

1985

as those Nutrition

Feldman

Report, and

developed

been

month,

medical

From

Seattle. 2 Presented

our

and

own

Weinsier

other

efforts,

you heard about An outstanding

published

and

commit-

Roland

to be imple-

is ready

committees.

York

have

public

been

has been

the Department at the

Times

article

such

in the 1992 curriculum

I am

chagrined

not more than one-quarter ofmedical in nutrition, the same as 15 y ago.

in a New

schools

the general

from by Drs.

colleagues,

curriculum

Gap in Medical Education Nutrition,” Marion Burros

I

roles efforts

their

and

by interested

to report that today have a core course Last

leadership

Winick

by Dr Eleanor Young that Education Award Lecture.

mented

the official become the

benchmark journal in the field. A further aim, as originally stated, was to unify the science and practice of nutrition as it relates to clinical

You

an opresearch

evolved

that objective. The third was to provide a journal for publication of meritorious work on experimental, later added, clinical nutrition. This was accomplished the fledgling American organ of the society

in health

problem with nutrition education that problem has continued for the

The

for investigators

this tops heavily

objectives

that a major in 1960, and

portunity

ofhuman

2).

Committee Education,

the Committee

committees

the situation,

ommendation apparently never took hold. The initial objectives of the society were First, and topping the list, is the encouragement graduate

Issues,

clinical-nutrition

and to the public.” committees to promote

Information.

term in office, is, attempting

were

terminated

joint

Public

the

or another, in academic clinical nutrition. In an area that I will return to later, it was initially proposed that active members would be required to attend annual meetings and that membership

and

prepared

of AIN.

all of whom

not

Practice

reliable

community of active

these objectives, including the School and Residency Nutrition Clinical

The spark

to provide

to the professional has in place a host

promoting nutrition.

of Nutrition

as a division

to

was

was a spark.

appeared in the June 1992 issue of our journal. The first officers of the society, several of whom for many years in leading the society, are depicted From

founders

and

professions

formation ASCN

you that DrGoodhart recently collaborator for the famous

I inform a long-time

textbook,

health

for the future.

32 y ago. who

for Clinical

and,

but there

Goodhart,

nutrition

Society

the workings of our involved in so many

predictions

created

by Michelangelo,

idea ofASCN. Regretfully, died. Dr Maurice Shils, Goodhart

back

we are now,

recommendations

as depicted

American

fully understand We are now

to glance

to see where

to say,

quite

of the

(ASCN) do not and our objectives.

entitled

“The

schools Biggest

Even Among Certified Physicians wrote, “It’s as ifthe people who on

Mars

bombarded

of Medicine,

1992 American

Society

for

the with

last

decade.

information

University for Clinical

is run

While about

of Washington, Nutrition

April 30, in Baltimore. 3 Address correspondence to EL Bierman. Department Division of Metabolism. Endocrinology. and Nutrition, Washington, Seattle. WA 98195.

Annual

Meeting.

has been updated over the proper application to the

practice

the years and it of the findings

of medicine ..lin

and J C/in

related Nuir

1992:56:726-9.

Printed

in USA.

cD 1992 American

Society

of Medicine, University of

for Clinical

Nutrition

Downloaded from https://academic.oup.com/ajcn/article-abstract/56/4/726/4715522 by guest on 10 January 2019

Many Nutrition society

the

for Clinical

PRESIDENT’S

TABLE I The Americaii

Society

727

ADDRESS

for Clinical

Nutrition*

TABLE 2 ASCN objectives

Foundin

g officers

.

Encourage human

Richard W Vilter Robert E Olson

President President-Elect Secretary-Treasurer

Robert

The Council

Willard

Founded

May

medical

between

schools

school

was

and

one

diet

have

and

health,

generally

awarded

of the

medical

1960, with 69 charter

I.

award’s

make

was

committees

of

the subject”

( 1). My own

Excellence

in

of

to develop

a long

S

story

Nutrition

national

level.

the American PEN),

we

are

nutritional

a core

short,

including

a proposal

faculty

cardiology

One

award,

faculty

which

the

course

for

resistance

of

schools.

led

would

come

the

stick

Enteral

create

effort

Nutrition

federal

proposals

is to create

curriculum

with (AS-

support

preventive

faculty

award,

changes

in

support

a faculty

member,

in clinical

nutrition,

in an

for

a clinical

to the successful

the geriatrics

major

scientist

partment to become velopment of required in all years of medical will

and

to

award

This

to

ofthe

lobbying

and

analogous

award,

have

a biomedical

in ourjoint

for Parenteral

education.

nutrition of

Currently

Society

both medical

we all need

preferably existing

de-

to get behind

this

lobbying

in postgraduate

Improvement in

riculum

developed

nutrition,

committee

models

tion

to

This

We now have lowship training

Education

will

as medical-school

be corrected

an opportunity to develop program in clinical nutrition,

of or application developing

program

effort. I will

turn

ucation.

ASCN

published

(2). The infuriated

may

now the

that US

Boards

edu-

well

a standardized felpending approval

of Medicine

for a certificate drive

and

ofadded the

Pediatrics

qualifications.

entire

teaching

met

in 1978

frequently

know

for almost

the inner

A major

workings

symposium

ofthe was

published

This task-force work joint recommendations ucation Dictari’ nated

in the more Report” on diet and

report

of making

the

public

continue at that.

their scientific

with from

Hotel

was ground-breaking, by the US Department

We

got

rather

to

well.

which was (3).

leading to the first of Health, Ed-

to be our

objectives,

for

professionals

and

in the

future

that

we’ve

been

highly

suc-

what

have

and

I think

role.

original

an opportunity

health

nutrition,

investigators

to

we

present

done

and

to

discuss

research in human nutrition? First, we have our annual meeting. Further, we have managed to build our society investigators in clinical nutrition as the field has grown the

growth

original 69 charter in total membership,

the bulk sees this

In recent

members. Figure 1 depicts the most of which represents active

years there

of the membership remarkable break

reflecting

the efforts

fino,

to increase

bers.

However,

Secretariat We

with is again

the number

attending

ofindividuals

more

retirees,

Dr Stephen

now

have

to our

regard

more problematic. The total membership

for

under

membership.

the story

been

but

in the active category. One growth curve, the increase

in the

ofthe

our

have

is still

depicted

mem-

meeting

in Figure

the annual

Schiaf-

1200

annual

2, and

meeting

is here

is shown

1200

The

and

and

Department of Agriculture, (4), and these efforts culmi-

for

clinical

to our

return

Hilton

1979

held at our 1979 meetings, as a supplement in ourjournal

recommendations

cessful

and

thorough, detailed, and updated “Surgeon (5) and the National Academy of Science’s health (6). We continue to fulfill the major

regarding

should To

O’Hare

and Welfare and the US Gl1idelints#{149} for Americans

General’s

aim

a year

U

1000

training

U

during

recall

by the

an exam

training

was

ie, residency

despite a terrific curCommittee. As the

a shortage of nutrition-oriented physician the major constraint on teaching nutri-

is probably

residents.

training,

stalled,

is corrected.

cation

the

medical

similarly

by the ASCN

concluded,

role

ago

has

in the role of

evidence and underpinnings to be made to the public.

membership.

effort.

training

education

disease.

in 1978 to investigate the scientific for any dietary recommendations

provide

a role model and focal point for the deand elective clinical nutrition curricula school training. With the financial carrot and

and

Provide an opportunity for investigators to present and discuss their research in human nutrition. Provide a journal or journals for publication of meritorious work on experimental (and clinical) nutrition. Further aim: to unify the science and practice of nutrition as it relates to clinical medicine.

subsequently

the school’s curriculum committee was profound and turf issues surfaced, particularly among basic science departments that believe they are covering nutrition topics perfectly adequately, which doomed our efforts to failure. We need a political push at the

and graduate

in health

(all MDs).

curriculum

Center

goals

To

members

ignored

a Pew

students.

.

undergraduate

nutrition

to our

took

efforts

in public

a pioneering

presidency

of

and

Dr

a few staffmembers

Senate a report

decided entitled

report said some a lot of people,

no scientific

ommendations.

support ASCN,

good but and

Hirsch.

McGovern

the entire

“Dietary

professional

leadership

Jules

ofthe

what

and

public

role Many

2

a decade of you

Committee should

800

ed-

eat

E

will

documentation

for any role,

ofthe

set up a task

U..

400

in

U... U U

and

200

Goals for the United States” things and some bad things and the bottom line was that there

in a pioneering

600

z . U

0 1960

1970

1975

1980

1985

1990

1995

Year

recforce

,

.

1965

FIG

1 . Number

of members

of ASCN

for each

calender

year since

1960.

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the relation

E Hodges

A Krehl Robert S Goodhart William B Bean S 0 Walfe

Editor *

.

(1960)

728

BIERMAN TABLE Reasons

% Registrat

3 for not attending

800

40

600

30

Too many competing In primary specialty

.

Lack

.

Scientific

American

z 400

20

tratioA

200

I’d 0)

O

C)

C

0)

O

O

0)

0$

)

O

O

0)

like

relatively

stable

at this

bership is now our membership

is

been

centage

When meeting

is appalling,

isn’t

and

of our

choice

continued

forward

Society

for Clinical Research, clinical

included ation

of American

annual

meeting;

membership’s

until year.

of all the explored.

only with

A “nutrition

The journal rate ensures

However,

I am

sure

know,

with not

AIN

at the

is being

week”

able

aside

from

providing

free travel

originally

This

journal. had

I cannot

say

editors

superb

Mendeloff,

under

current

Our

goal

turn

by our

stated

is important

and

Dr Norman

from

over

we look

Kretchmer.

from four institutes: Digestive and Kidney

to the

that

objective

its quality

that,

is foremost

although in many

the

largest

proportion

three-fourths)

and

of nutrition most

emanates

the National Institute of Diabetes Diseases (NIDDK), the National

Institute followed

Health

and

number

ofinvestigator-initiated

Human

of

support for research in clinical ofan eternal NIH-funding crisis.

(

NIH

is to ensure

founders,

because

comes

(NHLBI), and by the National

Development

the

National Institute

of

Since

1988,

(NICHD). projects

and Heart,

funded

by NIH

Cancer Child the

dropped

from one-third to one-fifth of approved applications, with no increase in the number of applications. The proportion of research support devoted to nutrition, from figures from the NIH nutrition-research coordinating group, suggests a constant value of 4% of NIH dollars going to nutrition research (actually, now 3.7%) (Figure 3). This is probably an optimistic percentage because what is considered nutriinstitutes are surveyed 4% is extraordinarily

tion when the various liberally. Despite that, in the

context

morbidity

of the relationship

and mortality.

of diet

This

may

is interpreted rather low when considered

to our

or may

from NIH, including the strategic plan promoted,

major

causes

of

not be corrected

with

women’s health then held back,

initithen

been and

we will proposed this

our

0

Nutrition

S%

w U)

3.0

200,000

Current

$

150,000

2.0

be for is

100,000

Constant

z U)

S

0

1.0 50,000

for

I’m preachattending this

for everyone.

Current

C

option

planned

in the

4.0

I,

leadership

role of this society will welcome any suggestions for ways that we can improve our annual meeting to attract more ofthe membership,

Dr Albert

excellence

continue. least, I will

250,000

Feder-

to track

is being

successors

10 under

published.

and attractiveness Last, but not

now

(FASEB)

although has

the have

of the

we are

Biology been

about

it. We

the American for

societies

my

a third

the

1997 and we are planning to participate. Obviously, ing to the converted because you are sitting here meeting.

needs

receives many high-quality papers and its acceptance that the highest-quality research in clinical nutrition

the new thrust ative, and the

majority

Federation

week”

A “clinical-research

in other

The

Physicians,

meeting,

nutrition-related

speak-

American As you

we have

re-

of American together

at that

half

respondents

selective;

for Experimental

now

con-

state-of-the-art

but

societies.

Societies

a few in

than

the

to meet the

Association

attendance

to next

meeting,

meetings

more

be more

essential

investigation

only

for the program.

Investigation, the

societies

ofconcurrent oral sessions, at this meeting. Most felt

should

it was

in periodic

being

more

work

a spring

felt that

per-

recently

meeting,

symposia,

of abstracts

Clinical

meetings

and

annual

higher-quality

listed

Committee

membership,

more

figure

attendance

about

the last

Lung, and Blood Institute (NCI),

of active

our annual meeting for more ofour mem-

and I’ve

now

things

to continued

funding

research?

reasons

to the

to prefer

respondents

able

with

Planning

regard have

getting

other

their

Long-Range

With

the

words,

has mem-

the

of the professional

a slight majority was in favor have seemed highly successful

and

that

discuss

give many

percentage is calculated,

What’s the problem it an attractive opportunity

a survey

which

exceeding

to the total

it is the lowest

for any

membership

felt we should ers,

and

the

I belong.

sponded.

years

attending

of ASCN.

3. Our

ducted

ofpeople

our annual

members

Table

recent

As the membership

400.

>

attending

bers to present Our

already

members

of the

to which and why

not meet

do

our minds: ensuring adequate nutrition. We are in the midst

30%. But this registration figure does not reflect because more than halfofthe registrants have

15%. This