If not for his interest in nutrition, Samuel Klein, M.D., might never have gone to medical school. Originally, he was planning to become a marine biologist. There’s still some evidence of his first career choice in the corner of his office, where a tank full of exotic fish gurgles.
But science and Klein both benefited from his decision.
“When I was in college, I became more interested in human metabolism and nutrition than in fish. Also, my ears hurt when I tried to scuba dive, and I got seasick during my first research voyage, so marine biology was out,” he jokes.
A first generation American, Klein’s parents are Holocaust survivors who met in a displaced persons camp after World War II, and his older brother was born in Germany before the family moved to the United States. Klein’s parents stressed the importance of education to their children to help them appreciate the opportunities available in this country.
Klein, the Danforth Professor of Medicine and Nutritional Science, heads the Division of Geriatrics and Nutritional Science, runs the University’s Center for Human Nutrition and is the medical director of both the University’s Weight Management Center and the Nutrition Support Service at Barnes-Jewish Hospital.
Many of these positions didn’t really exist before he arrived. But that’s not surprising. Klein works in a specialty that didn’t really exist when he was being trained. A graduate of Brandeis University and the Temple University School of Medicine, Klein completed research and clinical fellowships in nutrition and gastroenterology and later earned a master’s degree in nutritional biochemistry and metabolism from Massachusetts Institute of Technology.
In the early 1990s, David H. Alpers, M.D., the William B. Kountz Professor of Medicine, and then head of gastroenterology, began working to convince Klein to come to the University. He recognized Klein’s talent as a clinical investigator and wanted him in St. Louis.
“I knew he would be good when I recruited him, but he has far surpassed my expectations,” Alpers says. “It did take some time to convince him, however. Sam is a cautious man and doesn’t make decisions rapidly. His recruitment took more than two years, but he always reminds me how worthwhile the wait was.”
Compassionate care
Klein’s major research interest involves learning how obesity contributes to metabolic diseases, such as diabetes and fatty liver disease, and his entire research program involves studying human participants.
When humans are involved, scientists can integrate information from cellular, organ system and whole body levels to gain a comprehensive understanding of disease.
“Trying to understand how obesity causes so many diseases is scientifically challenging, but we need to remember that obesity also has serious personal consequences,” Klein says. “Obese people are the targets of bias and discrimination, which can have a dramatic effect on quality of life.”
Klein doesn’t know about those negative effects firsthand. A former track and cross country runner, he’s thin and energetic. But he feels he’s worked with enough obese patients to understand some of what they go through.
Sometimes they take some convincing, but his caring manner usually wins them over.
That was Beth Henk’s experience. Henk is now the program manager of the Weight Management Center.
But nine years ago — when she met Klein — she was a patient who weighed more than 700 pounds.
At the time, she didn’t think he could understand what her life was like, and she asked him some tough questions.
“When I first met Dr. Klein, I was praying to God to die,” she recalls. “I had hit the bottom of my strength.
“We sat down and he looked me right in the eye and gave me direct answers, and I finally felt I had found someone who would listen and help me. It amazes me how much he ‘gets it,’ which is very rare in someone who doesn’t battle obesity.”
With the help of diet, exercise and gastric bypass surgery provided through the Weight Management Center, Henk has lost more than 500 pounds.
Today, married with a toddler at home, she is convinced those things would not have been possible without Klein. And at the Weight Management Center, she now helps calm skeptics who wonder whether Klein really can understand them.
Stirring the low-carb pot
But even as obese patients come to trust him, some of Klein’s fellow nutrition researchers have raised their eyebrows at his work.
Recently, he investigated whe-ther removing large amounts of abdominal fat with liposuction might lower the risk of diabetes, heart disease and other metabolic problems associated with obesity.
|
Samuel Klein Hometown: Philadelphia, Penn. Education: B.A., Brandeis University, 1974; M.D., Temple University School of Medicine, 1979; M.S. in Nutritional Biochemistry and Metabolism, Massachusetts Institute of Technology, 1984 University position: William H. Danforth Professor of Medicine and the director of the Center for Human Nutrition Family: Wife: Hilary Klein, M.D., professor of psychiatry at Saint Louis University School of Medicine; two children. “I met my wife in junior high school in homeroom. She was kind of a goody two-shoes, and I was more of a James Dean type, or maybe like an early Brando. But don’t ask her about that because she’s too embarrassed to confirm it.” |
As it turns out, it didn’t.
He also helped organize the first multicenter, clinical trial of the low-carbohydrate Atkin’s diet to see whether low carbohydrate intake might help obese people lose weight. It did.
“Some colleagues are almost angry that our results showed a low-carbohydrate diet can have beneficial effects,” Klein says. “But we need to let data, not dogma, tell us what are the best approaches for treating obesity.”
In the study, the Atkins’ diet produced greater short-term weight loss than a low-fat diet and significant improvements in blood lipid levels.
Klein now is studying the long-term effects of the Atkins’ diet in a National Institutes of Health-funded research trial.
He wants to learn whether low-carbohydrate diets can help people lose weight and maintain weight loss, but he’s also monitoring other things to make sure it’s a healthy weight loss. He says it’s not as simple as just choosing a diet that causes you to lose the most weight.
“Losing weight usually improves quality of life, physical function and medical health in obese persons,” he says. “But, like any medical intervention for a chronic disease, it’s important to evaluate the long-term efficacy and safety of any diet therapy.”
Community outreach
The Center for Human Nutrition is one of only eight NIH-funded nutrition centers in the nation. Klein credits the talented faculty and the center’s strong research base with attracting that funding.
Recently, the center launched a community-based program to address obesity.
Under the direction of Richard Stein, Ph.D., research assistant professor of medicine, the center will design and evaluate weight-management courses given at the Y.M.C.A. to help improve health and reduce obesity in families.
The center’s work in obesity and diabetes prevention also has prompted a grant from the Kilo Diabetes Foundation to promote research into the prevention and treatment of obesity and the connections between obesity and type 2 diabetes.
In addition, a gift from Veronica Atkins and the Atkins Foundation, has allowed the Department of Medicine to establish the Robert Atkins Professorship in Medicine and Obesity Research, the first endowed obesity chair in the country.
Klein recently recruited Nada Abumrad, Ph.D., a renowned cellular lipid physiologist to fill the position and work to translate advances from basic science to clinical application.
The center — which began in 1994 as a program that housed two investigators, Klein and fellow researcher Bruce Patterson, Ph.D., research associate professor of medicine — now includes 19 faculty members and a talented group of administrative staff, research coordinators, and laboratory personnel.
The center’s combination of research, clinical care and community outreach makes it one of the most comprehensive nutrition and obesity programs in the country.
But apart from those activities, there’s an important question to answer: What does Sam Klein eat?
He says most days his diet is pretty boring: cereal with milk for breakfast, a sandwich and maybe some yogurt for lunch and some kind of meat or pasta dish at dinner.
He snacks on fruits, vegetables and nuts between meals. For his kids, however, he recommends different things.
“My children are extremely thin, and I try to get as much food into them as possible, including junk food, but nothing works,” he laughs.
“They don’t like junk food! Their eating behavior underscores the complexity of how we regulate food intake. It can be very difficult to get some people to eat and others not to eat.”