Gordon Jensen, M.D., examines patient Sheri Swope in the Center for Human Nutrition.
photo by Dana Johnson
Jensen to lead national nutrition society
Gordon L. Jensen, M.D., Ph.D., director of Vanderbilt's Center for Human Nutrition and professor of Medicine, filled the top spot of the nation's leading multidisciplinary nutrition society recently. The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) passed the gavel of the presidency to Jensen at its annual meeting in Orlando, Fla.
“I'm honored to have been chosen to lead this pre-eminent organization,” Jensen said. “In my leadership role, I hope to continue to foster the appropriate evolution to emphasize obesity and nutritional care in the various aspects of medicine.”
A.S.P.E.N. is an interdisciplinary nutrition society dedicated to patient-centered clinical practice through advocacy, education and research in specialized nutrition support. The society's membership of 5,500 is comprised of physicians, nurses, dietitians, pharmacists and researchers involved in the field of specialized nutrition support.
Jensen takes the helm of the society at a time when, he says, nutrition has garnered public interest, but the greater medical community has yet to fully get on board.
“Historically, medicine has been all about treating the outcomes of disease, not preventing disease,” he said. “Now, practically speaking, that doesn't make a whole lot of sense when we have a public health crisis of obesity that extends from children to the elderly. I think you're going to see a growing focus on preventative public health measures and, in medicine, on obesity and nutrition.”
As director of Vanderbilt's Center for Human Nutrition, Jensen, a physician nutrition specialist, has been leading a multidisciplinary effort to address the various aspects of nutrition through patient care, teaching and research. The center, which opened in 2000, has experienced tremendous growth and now does in excess of 1,500 inpatient and outpatient consultations annually.
“Our nutritional care spans the entire spectrum of medical care, from intensive care patients to the home setting, and from high-tech intravenous feeding of a patient with no intestines to management of the complicated patient with morbid obesity,” Jensen said. “We pull in referrals from all the surrounding states because there just isn't another resource that provides this range of expertise and service.”
As the problem of obesity continues to grow, the center is increasing its ability to respond. Heidi J. Silver, Ph.D., research assistant professor of Medicine, and Sattar A. Hadi, M.D., assistant professor of Medicine, joined the faculty in the past year, bringing an increased focus to the medical and surgical management of obesity and its complications.
“We're building a strong collaboration with the obesity surgery program directed by Richards [William Richards, M.D., professor of Surgery]. Vanderbilt has skilled and experienced surgeons and we seek to provide the appropriate evaluation, education and follow up that are required for successful weight loss surgery outcomes,” Jensen said.
“Unfortunately, a growing number of our referrals are now coming from those who have had bariatric surgery at other institutions and suffer unfortunate complications. We're seeing patients with life-threatening malnutrition, who require specialized intravenous or tube-feedings, resuscitation and some ultimately require reparative surgery. Patients seeking obesity surgery will be well-advised to consult comprehensive centers that can deliver the complex multidisciplinary care that is needed,” he said.
The Center for Human Nutrition also supports a comprehensive medical weight loss program, which is managed by Hadi. Those who are significantly overweight with medical problems can enter into a physician-supervised program that involves a prudent diet, physical activity and behavior modification, and in some cases, appetite-modulating medications.
Along with patient care, the center is involved in research that is investigating the impact nutrition has on various populations. Specifically, Jensen is looking at obesity among the elderly.
“We have recently identified obesity as a significant risk factor for functional decline and for risk of becoming homebound among the elderly,” he said. This work, he said, is changing the viewpoint that older people tend to be tiny and frail.
“Now we're seeing older people who are big and frail,” he said. Jensen said they have also found that many of these older, obese people are actually malnourished.
“They are eating very poor quality diets and actually have micronutrient deficiencies, although they are not for want of food energy or calories,” Jensen said. “It highlights an interesting dilemma, that you can actually be over-nourished and under-nourished at the same time.”
In particular, B-vitamin deficiencies associated with elevated homocysteine are prevalent and are in turn associated with increased risk for cardiovascular disease, stroke, dementia and osteoporosis.
Jensen said he hopes these findings will impact the different programs servicing those homebound, which have traditionally been tailored to undernourished people, not overweight or obese people.
The Center for Human Nutrition is also focusing on teaching the medical community to be more aware of the nutritional needs among their patients. Currently, the Center teaches a nutrition course required for all Vanderbilt second-year medical students, as well as offering nutritional guidance to multiple disciplines across the Medical Center.
“Nutrition is such a young, rapidly evolving field,” Jensen said. “It's an exciting time to be doing research, to be helping to lead Vanderbilt's nutritional efforts, and to be leading a national nutrition organization towards bringing the best nutritional care to our community.”
Jensen joined Vanderbilt University Medical Center in 1998 after serving as director of the Section of Nutrition at Penn State Geisinger Medical Center for 10 years. He received his medical degree from Cornell University Medical College and his Ph.D. in nutritional biochemistry from Cornell University. Jensen completed his residency training in Internal Medicine and fellowship training in Clinical Nutrition at New England Deaconess Hospital, Harvard Medical School.