How did you become interested in researching dietary supplements?
It began over a decade ago. A young man in his thirties came to see me after testing positive for amphetamines. That result had cost him his job with the local trash collection service, and he was distraught. He asked whether the weight loss pills he had been taking could be the source of the drug. Although the pills did not list amphetamine as an ingredient, when we tested them we found they contained fenproporex, an amphetamine-type drug that was not approved for use in the United States. I wanted to know how this could happen. Investigating that question eventually led to my researching the safety of weight-loss supplements. I’ve become especially interested in supplements that are advertised as containing only natural components but in fact contain banned drugs.
Do you take an international perspective in your research?
I do. I care for a lot of immigrant patients; many remind me of my grandfather, who was an immigrant to this country. When I find people marketing bogus weight-loss products to people with limited health literacy, I am compelled to investigate the situation. Some of those investigations have helped local immigrant communities, and some have led to action by the U.S. Food and Drug Administration. That agency recently banned three stimulants that we had studied and that are found in weight-loss supplements. That outcome is very satisfying.
What does clinical practice bring to your research?
I’ve found it to be profoundly invigorating to incorporate clinical work with research. It adds an important level of engagement. We survey patients for their use of a particular product, recruit them to our studies, and provide them care all at the same time. This process also gets our residents and medical students engaged in research.
How does teaching factor into your work?
I’ve remained involved with precept students and residents. As educators, we’re teaching students not just about research findings but about how those findings can be incorporated into clinical care. I’ve developed an interest in the concept of slow medicine, a more conservative approach to caring for patients. In this approach, we teach residents and students the importance of taking careful histories and of performing physicals without depending on unnecessary diagnostic testing or excessive treatments or screening tests.
Is there a common thread to your work in teaching, supplement research, and slow medicine?
The thread is caring for patients. For me, it is a tremendous privilege to have patient care be a part of everything I do. We’re always trying to push the needle a little, trying to help our patients be a little healthier. It’s about helping as many people as possible by learning from patients, looking at patterns that emerge from clinical work, and then working to boost health in the broader community.
Photo: John Soares