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How a Love of Food Influenced an IBD Researcher’s Outlook

Dr. Kevin Whelan readily admits to being a consummate foodie. He confesses to being one of those “dreaded” people who photographs a good meal and asks strangers what they’re eating. He’s passionate about how food brings people together—a source of physical, social and familial nourishment.

His long-held fascination with both food and science led him to study biochemistry as an undergrad, followed by a Masters in Nutrition and Dietetics. After working as a dietician specializing in the management of patients with gastrointestinal disease, he completed his PhD at King’s College London, investigating prebiotics and the gut microbiome. His doctoral research—demonstrating that prebiotics modify gut bacteria in healthy subjects—led to a pivotal moment in his career.

He had been working with colleagues who were interested in how bacteria influenced the immune system in Inflammatory Bowel Disease (IBD). Dr. Whelan proposed that they combine their research to test a chain effect, beginning with prebiotics as a dietary intervention. Perhaps prebiotics could modify gut bacteria in ways that positively influence the immune system and dampen inflammation to reduce IBD symptoms. In a randomized trial of 103 IBD patients, however, the result was quite the opposite—prebiotic carbohydrates actually induced gut symptoms in IBD patients.

While disappointing, Dr. Whelan decided to turn the finding on its head. What if these highly fermentable carbohydrates (fermentable oligosaccharide, disaccharide, monosaccharide and polyols or “FODMAPs”) were removed from the diet in IBD? In 2015, funding from the Kenneth Rainin Foundation underwrote the first-ever trial of the low FODMAP diet on functional gut symptoms, gut microbiota and immunology in patients with Crohn’s disease.

It’s Complicated 

As Professor of Dietetics and Head of Nutritional Sciences at King’s College London, complexity features prominently in Dr. Whelan’s work. For people with IBD, food can be a source of practical conflict and physical distress. Even dietary changes intended to help them are fraught with logistical and emotion-laden challenges. Patients must modify not only what they eat (and may have loved) but how they shop and cook and organize their lives.

Research into diet modifications is equally confounding. Designing both clinical controls for the targeted intervention and a convincing placebo for the control group are enormously complex. Both require behavioral changes that can be difficult for study participants to manage. Decreasing one ingredient requires increasing another to maintain nutrient content. The control group must also believe their placebo is the intervention, requiring a much more elaborate ruse than just a lookalike pill.

Life would be so much easier if I was focused on a single receptor target or drug. Instead, I focus on diet which involves molecules, nutrients, foods, people, populations, environments, psychology and sociology! …

It takes a multifaceted “dream team” to design such studies—combining a dietician, gastroenterologist, microbiologist and immunologist. And teamwork itself is complicated to manage, regardless of the context. In Dr. Whelan’s experience, just scheduling a meeting can be difficult—especially across international time zones. Yet the complex etiology of IBD requires a cross disciplinary approach. And he knows first-hand that bringing together wide-ranging clinical and scientific expertise results in better research outcomes.

From the Lab to Real Life 

Equally important is making sure new discoveries are applied to patient care. Recent animal studies on food additives for example revealed impacts on the gut microbiome and gut lining. Dr. Whelan’s next step is turning that into a human story. His research will focus on altering food additives in the diet of IBD patients to identify changes in their microbiology, immunology and clinical outcomes.

New discoveries are important. But educating patients, developing the next generation of champions in nutrition and applying new findings to patient care is even more so.

Dr. Whelan’s deep appreciation for food as nourishment encompasses its relationship to both health and disease. With increasingly strong science to back him up, he’s an enthusiastic advocate for dietary interventions in IBD. He champions nutrition and diet among his students and through professional and patient-focused associations. As a dietician, Dr. Whelan’s clinical experience with patients has profoundly affected his desire to ease the inherent tensions around food. As a foodie, it’s another good reason to talk about what’s for dinner.

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