Georgetown biochemist Thomas Sherman aims to teach medical and graduate students personal nutrition

Jonathan Newton/THE WASHINGTON POST - Georgetown University research assistant Nour Al-muhtasib serves herself as Thomas Sherman, a molecular neuroendocrinologist, talks during a nutrition potluck.

Pre-med student Katie Berky warmsup her spicy tomato soup in the crockpot down the hall. Professor Adriane Fugh-Berman places a tall vase of purple irises on the table with the plates and forks. Other students angle for a spot to put their kale, spinach and fruit salads.

Some carry Whole Foods containers of chickpeas and orzo; others have homemade dishes. There’s no bottle of creamy ranch or luscious Thousand Island with bits of salty-bacon goodness to dress the salads today, only Bolthouse Farms Extra Virgin Olive Oil Vinaigrette.

(Astrid Riecken/FOR THE WASHINGTON POST) - Sherman, his wife, Guinevive, and their two daughters, Annabelle, 4, and 20-month-old Philippe, prepare dinner at their Potomac home.

You wonder if you’ve stumbled into the wrong place. This is a college campus, right?

If this were any other day, a bowl of Alacia Strafford’s banana pudding — 27 grams of sugar per 2/3 cup — could have put you in a diabetic coma. But when cooking for this potluck lunch hosted by Georgetown University medical school professor and biochemist Thomas Sherman, the 25-year-old aspiring pediatrician replaced most of the fat and sugar with low-fat instant banana pudding, fat-free milk, sugar-free vanilla wafers and plain low-fat yogurt.

How’s it taste?

“It’s actually pretty good,” Strafford says. “It tastes like it wasn’t made with low-calorie stuff.”

Sherman, a molecular neuroendocrinologist and self-professed lover of metabolism, noticed that his medical students, notorious for their poor eating habits, sat up in class when his biochemistry lectures incorporated a more practical discussion of how the body responds to food. “It’s one thing to teach these fairly intricate pathways of metabolism and what happens to a protein when it gets digested and broken into little pieces, and how’s the energy extracted from it. I think it’s fascinating, but students think of it as memorization,” Sherman says.

“But what I would notice is that when I would relate these pathways to actual food — how does your body adapt to overfeeding or breastfeeding or exercise or alcoholism ... then they were paying attention in a way that they never did before,” continues Sherman, who has taught at Georgetown for 16 years.

So, he set out to give them more of what they wanted and, along the way, spread his belief that although medical interventions are sometimes necessary, many of the things that are killing us can be thwarted with better nutrition.

As a member of a panel tasked with reshaping the first-year medical curriculum, Sherman proposed a personal nutrition course to the university’s Committee on Medical Education in spring 2004. But it would take four years for Sherman and the committee to reach a compromise: He could teach personal nutrition if students also received traditional clinical nutrition instruction that answers questions such as what to feed a comatose patient or a cancer patient after chemotherapy. Sherman formed a partnership with the University of North Carolina to provide the clinical portion online.

Stephen Ray Mitchell, dean for medical education and a pediatrician, acknowledges that proposing new things to the committee is not easy. “They are a conservative group who feel protective of the curricular quality,” he says. He said the school previously taught students about nutritional assessments of patients, “but Tom has made this come alive since he took over leadership, by personalizing it in such an exciting way.”

Sherman hopes for a medical revolution, but right now, he’ll start with the 400 students — first-year med students and grad students in pharmacology and physiology — he must convince that nutrition is a valuable part of their young, lean lives, and not just for older, overweight people. He knows that to change the lives of future patients, he first has to go through current students.

“Now, can you convince them that it’s sufficiently important? That they want to be evangelists of nutrition for their patients? Actually, I think we can,” he says.

He’ll have to. According to the latest study on obesity published in the American Journal of Preventive Medicine, 42 percent of American adults will be obese by 2030. He says he has to make his students realize that the majority of them will spend their clinical time seeing patients with diabetes, cardiovascular disease, hypertension, high cholesterol and cancer — all primarily nutrition-related.

Sherman hopes to expand his reach to third- and fourth-year medical students. His success is measured in student evaluations and comments and their performance in biochemistry now that nutrition is taught alongside. Nearly half of his grad students have chosen to write their year-end physiology papers on nutrition-related topics.

On one day in Sherman’s office, a student pokes her head in to ask for leniency on a project. She reminds him that she missed the class where they had to defend their favorite vegetable. He asks how her sister is doing. Not well. He grants her the reprieve. It’s plain to see how he has become a sounding board for his students. He’s their running buddy, their vegetable virtuoso, their advocate. Nutrition is personal, and over the years, they have disclosed their eating habits in mouthfuls.

“Students will come up with these bizarre confessions like, ‘Dr. Sherman, I eat five pounds of Brussels sprouts a week.’ ... Or someone else will say, ‘I eat Chipotle burritos for lunch and dinner every day,’ ” he says. “Their diets are all over the place. A lot of them don’t know how to cook. So, when you give them nutrition advice, you have to give them cooking advice.

“My favorite is when you have a student that will make a pasta dish — pasta with olive oil and maybe a little butter and some green onions and fresh Parmesan — and then they’ll go, ‘Whoa, that worked really well,’ and then they’ll have a dinner party, and they’ll make pasta. They’re so proud.”

***

Sherman, 57, has been a runner since seventh grade and is from a large family of active siblings. His father, a Ball State University professor, biked to work. Growing up with four brothers and a sister, Sherman says the quantity of food took precedence over the quality, but luckily they never struggled with weight problems.

When it was time to settle on a major, the kid who loved science decided on chemistry, and when it was time to do research, he picked the brain metabolism lab because it was one of two labs open. In his first exposure to real metabolism, Sherman says, he learned how biochemical pathways in the brain responds to different diets. For him, that was a connection between the food you eat and how you metabolize that food.

For instance, he tries to explain to an English major, “if you’re on an Atkins diet, and you eat essentially a high fat-low carbohydrate diet, your carbohydrate-metabolizing enzymes remain, they’re just not busy. Whereas the fat-metabolizing enzymes are induced to accommodate [your increased amount of fat intake].” He was hooked and pursued it in graduate school.

When he started teaching personal nutrition to graduate and medical students, Sherman knew that moving from biochemistry to nutrition was more than just moving from molecular science to food science. It was a different kind of information; one that doesn’t allow for making hard-and-fast conclusions. He wanted to teach them to think critically, but broadly. Some students would say, “ ‘I hear you should eat this because it’s good’ [for you].’ But that’s almost a meaningless statement, because nobody eats one thing.

“You eat a whole bunch of things,” he points out, “and what you want at the end of the day, at the end of the week, at the end of the month, is that the foods you ate improved your health or sustained your health rather than put you at risk for things.”

Not everybody in the medical school agrees with everything Sherman believes. He has gone a few rounds with his colleague in the office next door over cow’s milk.

“This guy here,” Sherman says eyeballing the wall that separates them, “is an unabashed whole-milk drinker, and I just don’t understand it.”

Adam Myers, a 28-year-veteran in the department of pharmacology and physiology, believes that the personal nutrition classes are a good idea — and so is drinking milk.

Counters Sherman: “One: The special role of milk in the American diet is purely a function of marketing using false scientific data and the creation of invented deficiencies in calcium and protein and the risk of osteoporosis. The vast majority of the world’s population ceases to drink milk at weaning and does just fine, if not better. Two: If you drink milk because you like the taste of milk, then by all means drink it.”

Myers, who was among the faculty members who wanted the school to develop a broader view of nutrition, says he’s making sure that Sherman doesn’t go too far into the popular nutrition realm. So, the Krispy Kreme doughnuts and beer nuts that Myers has been known to bring to Sherman’s potlucks? Just keeping him balanced, Myers says.

Sherman acknowledges that some students get really into nutrition in a manner that’s not realistic or sustainable.

He says he has never been one for fads. He experimented with vegetarianism during graduate school, thinking it would increase his running endurance. “It didn’t,” he says. He paid more attention to the foods he ate. But he missed a good cheeseburger.

***

Alacia Strafford, who suffers from anemia, says she has not only discovered how to make healthful foods taste good, but also how iron supplements and certain enriched foods can improve her life.

“Everyone says you need to eat healthier but not necessarily how to eat healthier, how to pick fruits and vegetables, or even how to make them tastier. Overall, this class has made it clear that not every ailment or sickness needs to be prescribed medication.”

Tips she now uses every day: following the food pyramid as a guideline, reading nutrition labels, drinking plenty of water and reducing her sugar intake. And, as a future pediatrician, Strafford says it’s never too early to pass that knowledge on to her patients.

Sherman is like a beaming father when he hears that his students are getting something out of the class. It’s a nice contrast to what he hears some doctors say at medical conferences about their lack of faith in patients’ willingness to adopt better eating habits.

“What would be nice is if you have a category of physicians who are comfortable in talking to their patients about this: ‘I eat this way, and it makes me feel great. Tell me what you eat. Tell me what you do when you come home from work and you feed the kids. Tell me what you snack on,’ ” he says. “What you want is a doctor that tells them, ‘You know, I could give you this anti-hypertensive medication, but it has these side effects, and it’s going to cost you this much, and you’re going to be on it for the rest of your life. And the side effects of eating fruits and vegetables is maybe you’ll lose weight, maybe you’ll feel better, maybe you’ll save money.’ ”

Carla Broyles is a Washington Post staff writer. To comment on this story, send e-mail to wpmagazine@washpost.com.

 
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