A passion for nutrition started early for Wendelin Slusser, MD, MS. As a high school senior, she studied the health impact of nitrites, a food additive and preservative. As an undergraduate, she examined the role of sex hormones in controlling food intake and body weight.
During her college summers in New York City, she worked for a physician from Chile who observed that doctors in the U.S. didn’t know anything about nutrition. It prompted her to get her master’s degree in the subject before medical school.
Dr. Slusser is a clinical professor of pediatrics at both the David Geffen School of Medicine at UCLA and the UCLA Fielding School of Public Health and associate vice provost for the Semel Healthy Campus Initiative Center at UCLA.
In a nearly 30-year career at UCLA, Dr. Slusser has focused on nutrition as a cornerstone of health, not only with patients, but in her teaching. She developed a nutrition curriculum for pediatric residents across the state of California which showed shifts in patient behaviors around food, management of obesity and healthy eating. In addition, she has overseen a teaching kitchen as part of hands-on learning for medical, dental and nursing students, and pediatric residents.
Most recently, she was a member of a national expert panel calling for the inclusion of nutrition in medical education, an effort to improve physicians’ ability to offer nutrition counseling to their patients. Currently, less than a fifth of graduating physicians are prepared to do so.
“If a physician or a health care practitioner practices well-being in their own lives, they're more likely to talk about it in their practice and promote it in their practice,” said Dr. Slusser. “Hopefully, that will then impact the patients they work with.”
The need is greater than ever. Diet directly affects seven out of the 10 leading causes of death. It is predicted that 60% of current children will develop obesity before age 35. At the same time, almost 13% of the country has food insecurity.
In every stage of life, healthy eating plays a central role, Dr. Slusser says. “Nutrition is about nourishing yourself in a helpful way through your life course.”
Childhood habits
Pediatrics allows Dr. Slusser not only to impact a growing child’s well-being, but also to motivate an entire family to improve their diet. She counsels them to develop healthful habits and expose children early to healthful, delicious foods.
“For young children, you often have to present a food that they're not used to 15 times before they accept it,” she said.
Along with good habits, having an eating routine – breakfast, lunch, dinner, interspersed with snacks – is critical. Also important is mindful eating, without any distractions such as phones, computers and television, whether alone or with others.
“It's really quite comforting to be able to have a routine and know what you're going to expect,” said Dr. Slusser.
Families often cite time as an impediment to adopting a healthy diet. But Dr. Slusser said it’s possible to stock up and not have to buy fresh food every day or every few days. For example, frozen vegetables, without any added salt, are very healthy and economical.
The balance between activity levels and caloric intake is also important to consider, especially because extra sugar can creep into the diet. Dr. Slusser cautioned that drinks with added sugars are a big culprit among non-nutritious foods. They also impact dental health and how the body manages sugars in the liver.
“In a child’s early years, I tell families it's just a matter of 200 calories per day, such as just over one-and-a-half cups of apple juice,” she said.
Much of this evidence-based guidance is offered to patients in her team’s multidisciplinary UCLA Fit for Health Program, led by medical director Cambria Garell, MD. The clinic provides comprehensive management of nutrition, physical activity, psychological and overall health needs of children and adolescents with obesity.
Adult food insecurity
Dr. Slusser’s current work as head of the Semel Healthy Campus Initiative Center is focused on undergraduate and graduate students, trainees, staff and faculty. It’s an important aspect of reaching the center’s goal: establishing UCLA as the healthiest campus in the country as well as inspiring others.
“Healthy eating is very much directly related to academic performance, mental health and student health in general,” said Dr. Slusser. “We’re creating an environment that promotes health and well-being through building an inclusive culture of health. So, it's not only you individually but also your environment that can help support you. It’s a public health approach.”
One initiative is working closely with UCLA Dining Services to offer students delicious, healthful and affordable meals. Dr. Slusser noted that for the eighth year in a row, UCLA is the No. 1 dining service in the country. And when students move off campus, they can recreate the meals they enjoyed with UCLA’s Bruin Plate Cookbook.
The proceeds of the book support students who are food insecure, a group that Dr. Slusser works closely with. She recalled a mentee, a student who experienced food insecurity growing up and as a student at UCLA. The student explained how food was often central to going out with friends, an experience she couldn't afford. Therefore, addressing food insecurity not only meets students’ physical needs but can also support emotional and social well-being.
Research shows that if food insecurity is not addressed during college, that population of students will continue to be food insecure.
“We learned from our students with food insecurity that not only did they want to receive food they liked and fit into their culture, but they also wanted to learn how to prepare food,” said Dr. Slusser.
“A lot of students these days have lost the skills or never learned the skills to prepare food. They recognize this and are asking to learn how to prepare delicious food on a budget. This led us to build the UCLA Teaching Kitchen.”
Another resource for the campus community is the UCLA Rothman Family Institute for Food Studies, an interdisciplinary hub that celebrates the vital role that food plays in health, culture, tradition and identity, and expands global perspectives of food. The recently endowed institute will be an important nutrition resource, with a range of public engagement opportunities.
Diabetes and aging
Nutrition continues to have a sizeable impact on well-being in later years too. Dr. Slusser advised that optimizing the fuel put into our bodies can change, or at least influence, the outcomes of chronic conditions such as diabetes and cardiovascular disease.
She offered an example from her own life. One out of three Americans currently has prediabetes, but only one out of 10 knows it. During a routine checkup, Dr. Slusser was shocked to receive a diagnosis of prediabetes. She modified her diet immediately.
“I was able to remove my ice cream that I was eating at night – which I enjoyed royally – and I limited some of the other carbohydrates in my diet, and I reversed it,” she said. “I also added more protein and more complex carbohydrates. And I started cooking with different herbs to help maximize my carbohydrate metabolism, like cinnamon, sage and rosemary.”
In her work with UCLA Health’s Tannaz Moin, MD, MBA, MSHS, and Carol Mangione, MD, she learned about the Diabetes Prevention Program (DPP), which emphasizes increased physical activity and healthier food choices. In clinical trials, the program reduced the risk of developing type 2 diabetes by as much as 58% among adults with prediabetes and overweight/obesity.
To address diabetes awareness and help lower risk among faculty, staff and students, Dr. Slusser and Dr. Moin launched UCLA’s DPP in 2016. Two years later, the successful model was expanded to all UC campuses, at no cost to participants.
“If you learn what preventive actions you can take after being diagnosed with prediabetes, you can significantly lower your risk of developing type 2 diabetes,” said Dr. Slusser.
Another strategy to reduce chronic disease is cooking skills training. Dr. Moin, Dr. Slusser and Mopelola Adeyemo, MD, MPH, are leading a Teaching Kitchen Collaborative Multisite Trial at UCLA to explore the impact of “food as medicine.” The pilot study, Dr. Slusser said, “is a dream come true.”
