Week 3: A Talk with Dr. Galler
by Riana Balahadia
Hey Scientistas! This past week has been a very productive one so far. We’ve been working at Dr. Galler’s office in Brookline, looking through the file cabinets and organizing the data. Luckily, I was able to catch an interview with Dr. Galler in between patients. Check it out!
How did your interest in child malnutrition lead to the Barbados Nutrition Study?
I’ve always been interested in studies about developing countries and poverty and in children. But it was somewhat accidental. I was actually studying neurochemistry and ended up working with a professor who encouraged me to set up a rat laboratory for him. Four years later, when I was a resident, my mentor passed away and I salvaged his data in order to continue working on prenatal malnutrition in rats. But a new opportunity arose: to work on a human study in parallel to my rat studies. In the beginning of 1973, I received funds and visited countries in Latin America
and the Caribbean to search for a place to set my study. I serendipitously ended up in Barbados through a recommendation from a friend who knew Dr. Frank Ramsey, my future collaborator. Up until his death 3 years ago, Dr. Ramsey was a local Barbadian who was very involved in public policy and was the head of the medical school and Nutrition Center. He was a trained pediatrician in Barbados interested in doing research on malnourished children. And I was on the other end in the U.S. with a neurochemistry background in rat infant and prenatal malnutrition. It felt like a meeting of minds, and so we joined forces. That was how the Barbados Nutrition Study began.
Hey Scientistas! This past week has been a very productive one so far. We’ve been working at Dr. Galler’s office in Brookline, looking through the file cabinets and organizing the data. Luckily, I was able to catch an interview with Dr. Galler in between patients. Check it out!
How did your interest in child malnutrition lead to the Barbados Nutrition Study?
I’ve always been interested in studies about developing countries and poverty and in children. But it was somewhat accidental. I was actually studying neurochemistry and ended up working with a professor who encouraged me to set up a rat laboratory for him. Four years later, when I was a resident, my mentor passed away and I salvaged his data in order to continue working on prenatal malnutrition in rats. But a new opportunity arose: to work on a human study in parallel to my rat studies. In the beginning of 1973, I received funds and visited countries in Latin America
and the Caribbean to search for a place to set my study. I serendipitously ended up in Barbados through a recommendation from a friend who knew Dr. Frank Ramsey, my future collaborator. Up until his death 3 years ago, Dr. Ramsey was a local Barbadian who was very involved in public policy and was the head of the medical school and Nutrition Center. He was a trained pediatrician in Barbados interested in doing research on malnourished children. And I was on the other end in the U.S. with a neurochemistry background in rat infant and prenatal malnutrition. It felt like a meeting of minds, and so we joined forces. That was how the Barbados Nutrition Study began.
Why did you choose Barbados for your studies?
Barbados has a lot of advantages. The fact that it’s an English speaking country was very useful. Also, Barbados has a homogenous population of only 265,000 people that’s predominantly of African origin. Poverty levels were also not extreme. Therefore, we could conclude that our results were not due to large differences in genetic variability, or other socioeconomic or social factors. Being an island, people did not emigrate often, so we really had a vantage point. Now 42 years into the study, we still know where 99% of the original cohort is. The country also had excellent record keeping of school/health records, so we had precise information of each one of our children. But most of all, Dr. Ramsey was a wonderful collaborator who was very knowledgeable and held high influence both in the Ministry of Health and the country.
What type of challenges have you had to overcome in order to continue your study?
There have been many challenges. Looking over the past 42 years, it’s taken a lot of perseverance on my and Dr. Ramsey’s part to continue work that is this long. There were certainly many political challenges. Once, the study was shut down for 5 years because the ruling political party did not approve of our work. I would say that the biggest challenge has been finding funding. We originally relied on small 2-year grants from private foundations. We had
managed because Dr. Ramsey was head of the National Nutrition Center and had nurses working for him. But when the Center shut down, we realized that we didn’t have enough funding to continue the adult follow up. Now we’ve been on continuous funding from NIH. But it’s a challenge because every time there’s a grant renewal, you have to compete with others. Another
challenge we’ve faced is the evolution of science. With time, you have to strike a balance between choosing tests and tools that would provide continuity, without ignoring advancements in science.
What are some exciting key findings of the BNS?
When we did the study, we had a cohort of index children who were malnourished during their
first year of life only and were later rehabilitated through the Nutrition Intervention Program. We then matched each index child to a control child, who was within 3 months of age, the same sex, and same handedness. One of our earliest findings was that 60% of the malnourished group had attention deficits, according to teacher interviews, compared to 15% of the control group. In addition, when the children took the national high school exam, the index children did not do as well. We’ve found other adverse health outcomes of postnatal malnutrition, such as metabolic syndrome, obesity, and diabetes, particularly among the women. This year alone, we published 8
papers in different subjects. And because we kept close records on the socioeconomic status and living situations of both controls and index adults, we could tell that these consequences were due to early malnutrition. But looking at the bigger picture: I don’t think these are
isolated events, but perhaps the result of different gene expression in the brain. And that’s where I think the future of the study lies—in epigenetics. We’re currently pursuing preclinical studies
on rat brain development to see if these changes actually occur in response to malnutrition stimuli. I’m really excited about that.
What advice would you give to Scientistas?
The exciting thing about science is that there are so many unanswered questions. There’s always a question of how to prioritize things. However, it’s important to pursue things you’re passionate about and not to think too far ahead. I certainly didn’t plan on being involved in this study for 42 years. My advice would be to stay open-minded to new possibilities. Don’t limit yourself to what people think you should be doing, or even what you think you should be doing. I think there are many opportunities for women now compared to my day. Combining science with an exciting and productive career path is so much more possible now than it ever was! It’s important not to feel limited. It’s entirely possible to meld a career while you’re thinking about personal objectives, like family. Right now, science is different and more about collaboration and multidisciplinary approaches. I think science is a natural venue for women because, well, we are naturally multidisciplinary.
Barbados has a lot of advantages. The fact that it’s an English speaking country was very useful. Also, Barbados has a homogenous population of only 265,000 people that’s predominantly of African origin. Poverty levels were also not extreme. Therefore, we could conclude that our results were not due to large differences in genetic variability, or other socioeconomic or social factors. Being an island, people did not emigrate often, so we really had a vantage point. Now 42 years into the study, we still know where 99% of the original cohort is. The country also had excellent record keeping of school/health records, so we had precise information of each one of our children. But most of all, Dr. Ramsey was a wonderful collaborator who was very knowledgeable and held high influence both in the Ministry of Health and the country.
What type of challenges have you had to overcome in order to continue your study?
There have been many challenges. Looking over the past 42 years, it’s taken a lot of perseverance on my and Dr. Ramsey’s part to continue work that is this long. There were certainly many political challenges. Once, the study was shut down for 5 years because the ruling political party did not approve of our work. I would say that the biggest challenge has been finding funding. We originally relied on small 2-year grants from private foundations. We had
managed because Dr. Ramsey was head of the National Nutrition Center and had nurses working for him. But when the Center shut down, we realized that we didn’t have enough funding to continue the adult follow up. Now we’ve been on continuous funding from NIH. But it’s a challenge because every time there’s a grant renewal, you have to compete with others. Another
challenge we’ve faced is the evolution of science. With time, you have to strike a balance between choosing tests and tools that would provide continuity, without ignoring advancements in science.
What are some exciting key findings of the BNS?
When we did the study, we had a cohort of index children who were malnourished during their
first year of life only and were later rehabilitated through the Nutrition Intervention Program. We then matched each index child to a control child, who was within 3 months of age, the same sex, and same handedness. One of our earliest findings was that 60% of the malnourished group had attention deficits, according to teacher interviews, compared to 15% of the control group. In addition, when the children took the national high school exam, the index children did not do as well. We’ve found other adverse health outcomes of postnatal malnutrition, such as metabolic syndrome, obesity, and diabetes, particularly among the women. This year alone, we published 8
papers in different subjects. And because we kept close records on the socioeconomic status and living situations of both controls and index adults, we could tell that these consequences were due to early malnutrition. But looking at the bigger picture: I don’t think these are
isolated events, but perhaps the result of different gene expression in the brain. And that’s where I think the future of the study lies—in epigenetics. We’re currently pursuing preclinical studies
on rat brain development to see if these changes actually occur in response to malnutrition stimuli. I’m really excited about that.
What advice would you give to Scientistas?
The exciting thing about science is that there are so many unanswered questions. There’s always a question of how to prioritize things. However, it’s important to pursue things you’re passionate about and not to think too far ahead. I certainly didn’t plan on being involved in this study for 42 years. My advice would be to stay open-minded to new possibilities. Don’t limit yourself to what people think you should be doing, or even what you think you should be doing. I think there are many opportunities for women now compared to my day. Combining science with an exciting and productive career path is so much more possible now than it ever was! It’s important not to feel limited. It’s entirely possible to meld a career while you’re thinking about personal objectives, like family. Right now, science is different and more about collaboration and multidisciplinary approaches. I think science is a natural venue for women because, well, we are naturally multidisciplinary.
Dr. Janina R. Galler
About the Blogger
| Riana Balahadia is studying Human Evolutionary Biology with a secondary in Global Health & Health Policy and pre-med in Kirkland House at Harvard (class of 2014). During the semester she enjoys singing with the Veritones, a premier co-ed a capella group, and planning activities for Harvard Philippine Forum and the Undergraduate Global Health Forum. This summer she will be living in Winthrop as part of the SURF (Summer Undergraduate Research Fellowship) Program hosted by the Global Health Institute. Her mentor is Dr. Janina R. Galler, who has been working on the Barbados Nutrition Study (BNS) for the past 40 years. Riana's primary research will be on linking malnutrition and epigenetics to mental health, and then comparing that information with the BNS cohort in Barbados. She plans on listening to awesome music during her commutes to Judge Baker's Children Center in Mission Hill, Dr. Galler's office in Brookline, and the epigenetics lab in U Mass Medical School in Worcester. |
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