A Look into Nutrition: A Conversation with Professor Vasanti Malik

David H. Xiang

The role comprehensive nutrition research can play on affecting policies and the health of the general public is crucial, and something that can have a profound impact across many generations. Moreover, because of the multidisciplinary and complex nature of nutrition, and all its related factors, advancements in nutrition research often seep into other fields such as environmental health, engineering, biotechnology, even anthropology.

Professor Vasanti Malik, Adjunct Lecturer on Nutrition and Research Scientist at the Harvard School of Public Health, has dedicated her career and research on some of the most pressing issues in the field of nutrition. Not only does she teach several nutrition courses at Harvard College and the Harvard School of Public Health, but she has also conducted significant and impactful research on the role sugar sweetened beverages have on weight gain and cardiovascular health. Her work has been extensively cited, and Professor Malik has presented her research to government policymakers, other scientists, and a wide array of interested groups. David Xiang, Co-Director of Internal Development at HHPR, recently interviewed Professor Malik about her experiences, accomplishments, current work, and advice for people looking to follow in her footsteps.

David Xiang (DX): How did you become interested in nutrition? Did any event or person or book or moment inspire you?

Vasanti Malik (VM): I first became interested in nutrition during a third year (junior year) undergraduate biochemistry class that had a section on nutrition and metabolism. I was very impressed to learn about the profound effect that food can have on health and well-being, particularly related to cardiovascular health. Upon graduating, I decided that I wanted to explore the connection between nutrition and health in greater depth and more specifically through a lens of disease prevention.

DX: The field of nutrition seems to be a very multidisciplinary study, combining medicine, biology, public health, and policy. How has working in the intersection of medicine and policy changed over the years?

VM: The multidisciplinary nature of nutrition is one of the most interesting aspects of working in the field. I am fairly new to the scene (finished my post doc about 5 years ago) so it’s a little difficult to comment on how trends have changed over the years. Historically, nutrition research has played an important role in shaping policies but the process is usually quite slow and met by opposition from lobbyists (from industry or agriculture) with special interests. For example, it took decades of research to move the needle on trans fat legislation to remove it from the food supply in this country. But it seems to me that in more recent years some (but not all) nutrition policies are being implemented more quickly. Policies to reduce intake of added sugars and sugar sweetened beverages come to mind along with calorie labeling and, modifications to the nutrition facts panel and federal school lunch program. I’m not sure if this is related or not but there seems to be more stakeholders involved in moving policies forward as well as targeted political framing and there is much more widespread access to the media, 24/7 news cycle, social media and the internet which may support transparency and public demand.

DX: What notable accomplishments are you most proud of?

VM: I’m still fairly early in my career so these are few. I would say that my collective research on sugar sweetened beverage intake and weight gain and cardiovascular outcomes is something that I’m proud of because of the impact this body of work has made on shaping dietary guidelines and policies. When I was still a doctoral student in 2006, I led the first thorough systematic review linking sugary beverages with weight gain and adverse cardiovascular health. That paper is among the most highly cited on this topic and has been specifically used to guide dietary recommendations to limit intake of sugary beverages. Through this work I have also been invited to serve on grant review committees, participate in expert round tables with governments and consult for attorneys on cases related to sugary beverage litigation.

DX: What are some public health issues that you are passionate about, and working to address today?

VM: Reducing the burden of diabetes and related health conditions in low-and middle- income countries is a topic that I’m passionate about. Rates of diabetes have skyrocketed in low- and middle- income countries, many of which have co-existing undernutrition and high rates of communicable diseases. This puts a great deal of pressure on the economies of some of these countries that are already resource-limited, highlighting the importance of prevention.

DX: What is your current research focused on?

VM: Identifying dietary and lifestyle risk factors for obesity, diabetes and related conditions that can be used to provide the evidence-base to help shape nutrition policies to improve health.

DX: What is something you would like to eventually work on?

VM: I would like to expand my research in a few areas. The first is to focus on improving child health (i.e. body weight, diet, lifestyle and cardiovascular risk factors) as a way of tackling diabetes and cardiovascular risk down the road. Lifestyle habits form early and so do cardiovascular risk factors. I am also interested in conducting research that promotes diets and lifestyles to improve health but also environmental sustainability. I am also more broadly interested in nutrition communication and knowledge dissemination across different types of audiences- academic, lay, policymakers etc.

DX: What has been the hardest thing about working in the field of nutrition? What has been the best thing?

VM: As with other fields in the sciences, obtaining funding to support research is challenging in nutrition. More specifically related to nutrition, one challenge has been overcoming or responding to all of the nutrition misinformation that exists and trying to communicate research findings accurately to the media. Interestingly this has also been the best thing. I really enjoy communicating with the media and engaging with the public about nutrition research (my own and findings from others along with controversies in the field).

DX: What is your favorite class to teach, and why? What is the hardest, and why?

VM: My favorite class to teach is Advanced Obesity Epidemiology, which I co-teach with Professor Steve Gortmaker, who is in the Department of Social and Behavioral Sciences. It’s a graduate level class open to all departments at HSPH but required for those pursuing the obesity concentration. The class tends to be on the smaller side ranging from 5-12 students depending on the year so it feels like a seminar course. Because of the small size we’re able to have some really great class discussions and interactions with the guest speakers who are leaders in their respective fields. I always learn a lot from the students and speakers in that class. The most challenging class to teach is the undergraduate class on nutrition and global health mostly due to the logistics of teaching such a large class, which for many is fulfilling a gen ed requirement. I also step a little outside of my comfort zone in that class and teach about topics that aren’t within my areas of expertise, but it’s a good learning experience for me. That said, there are many aspects that I love about teaching that class such as the variety of students from a wide range of academic concentrations and I always get to work with a very devoted team of teaching fellows.

DX: What advice do you have for the next generation of people who are passionate about public health?

VM: To follow their passion and to develop a thick skin. It may take time to get the funding or stakeholders lined up and there will likely be disappointments along the way, which is part of why the work is rewarding when it comes to fruition so resilience is key. I also encourage the next generation to think broadly and multidisciplinary. It’s amazing how much synergy there can be across fields (think: nutrition, environmental health, policy, biotech, engineering, anthropology, geography), which can be used to create really interesting and innovative projects. Team research may also have an edge when it comes to funding.

DX: Assuming you have unlimited power, if you could change one thing about the public health infrastructure in America today, what would it be and why?

VM: Access to affordable and healthful foods (i.e. fruit, vegetables, whole grains) and safe drinking water for all individuals in all communities. Marked disparities exist in access to healthful foods (and clean water), which closely track with health disparities. Included in this would be that healthful foods should be the default choice across all food services.

DX: What has been the most rewarding thing about your research and work?

VM: Seeing how my research has played a role in shaping nutrition policies and dietary recommendations to improve health. Also being able to provide sound nutritional advice and “mythbusting” to friends and family has been really rewarding.