As chair-elect of the American Society for Nutrition’s Medical Nutrition Council, Connie Bales, PhD, RD, is working to strengthen ASN’s clinical nutrition initiatives and promote nutrition as a part of medical training and practice.
Dr. Bales is a professor of medicine (Geriatrics) at Duke and Associate Director for Education/Evaluation of the Geriatric, Research, Education, and Clinical Center (GRECC) at the Durham VA Medical Center. Bales’ research has ranged from basic bench work to large clinical trials with the overall goal of enhancing scientific understanding of the role of nutrition in the health and functional status of older adults. She is lead editor of the book Handbook of Clinical Nutrition and Aging, now in press for its Third Edition, and Editor in Chief of the Journal of Nutrition in Geriatrics and Gerontology.
Learn more about Bales’ new role, her interest in bringing the fields of nutrition and medicine together and her experience as an active member of a national professional organization.
Q. What is your new role with the American Society for Nutrition?
ASN is the premier research society dedicated to improving the quality of life through the science of nutrition and is divided into three councils. Members are encouraged to affiliate with one – Global Nutrition, Nutritional Science (for basic scientists), and the Medical Nutrition Council. Historically, clinical nutrition has not been as strong as basic science nutrition in ASN, but in recent years clinical nutrition has come into its own, and ASN has developed and begun to expand a Medical Nutrition Council (MNC). I will be only the third chair of the MNC, so it’s only existed this way for a few years.
Q. What will you be working on as chair of the MNC?
Anything I can do to make nutrition more of an integral part of medical training and practice would be a worthy accomplishment for the three years that I’ll be chair-elect, chair and past-chair. One responsibility is to continue to build the strength of clinical nutrition within the society and nationally. With regards to medical education, the NHLBI is starting a new initiative to promote nutrition education for trainees in a variety of health-related fields, including medicine. So, I’ll be helping with that initiative. So many things compete for inclusion in the medical curriculum, and because there is not a board certification in nutrition, it’s easy to push it aside. Yet medical students and practicing physicians recognize the importance and sometimes feel inadequately prepared in nutrition. It’s a pretty vast field, so it’s hard to keep up with when you have so many things to master, but there are ways we can do it better both in training and in CME delivery.
Q. How does your work with ASN fit in with your roles at Duke and the Durham VA Medical Center?
Because nutrition has historically been taught in state universities with a strong Agriculture component, there aren’t that many research nutritionists working in a medical school environment; relatively few have chosen the path that I chose. Being at the interface of nutrition and medicine is a very good place to be in terms of mentoring and helping people make connections, and it also complements my research. But it is important for me to keep connected with new developments and initiatives in the field of nutrition. The Medical Nutrition Council allows me to make connections with the few people across the country who are heavily involved in medical nutrition; some of them are MDs and some of them are PhD, RDs, like me. Serving on the MNC board is an opportunity for me to make connections with those people, and sometimes they lead to collaborations on research and education as well, which benefits my work at the Durham VA as well as Duke.
Q. What research projects are you currently working on?
I’m working on obesity interventions in older adults. There are some side effects of weight loss, like loss of muscle and bone, that happen when anyone loses weight but that are problematic for older adults. We’re working with older, obese adults, people that might be called “fat and frail.” They don’t look frail, but they are – to the point that some of them have trouble walking or doing activities of daily living. Normally you can exercise to help protect muscle and bone during weight loss, but this population can be quite limited in that regard. So this study goes along with my interest in helping people who cannot participate in traditional interventions improve their health outcomes. We have a weight loss control group that is doing normal protein levels and a high protein weight loss group, looking to see the effects on muscle and function. We’ve done weight reduction studies before, but this is the first time we’ve done it with a group that is functionally limited.
Q. What is exciting about this field to you?
A lot of nutrition is about primary prevention, which means, “eat this way and you won’t get heart disease,” or “eat this way and you won’t get osteoporosis,” but my interest has always been for people who already have a health problem to deal with. Most people over 65 have one or more chronic health conditions. What I’ve always wanted to do is work with that population because I think that it is so discouraging to think that, “oh, if you’d only eaten this way for the last 50 years, you might not have this condition.” What I want to do is secondary intervention, which means you have an individual who has a disease like heart disease or diabetes, and you do nutritional interventions to make the course of their disease better – either make them feel better, delay the progression or sometimes even resolve it, like you can with weight loss in some cases of Type 2 diabetes. So I work with middle aged and older patients who have a problem that could be improved by lifestyle interventions.
Q. What do you see being able to bring back to Duke from the Medical Nutrition Council?
It is important to keep up all aspects of the medical field, and many specialties, including nutrition, are rapidly evolving. I see this as an opportunity to make sure Duke is a part of national efforts in nutrition education and research. Additionally, with my visibility in the role, it will bring attention to all nutrition-related research at Duke, both basic science and clinical.
Q. Have you always been involved with national organizations?
I have always sought out involvement in national organizations, in part because there is not a nutrition department at Duke. It has turned out to be a really good thing to do because I’m always in touch with what’s going on in the field, and I’ve had wonderful collaborations over the years. I couldn’t have edited my book, Handbook of Clinical Nutrition and Aging, if I didn’t know so many of these experts across the field. I’ve found that being active in one or two key societies that are closest to what you do in the research world can make a huge difference. I think it contributed to my ability to get to the level of professor in a department where PhDs are few and far between, because I was able to do a lot of things on the national level. It really can be worth it to get involved in key professional societies and I would encourage junior faculty to consider it.