The primary goal of this training program in Nutrition is to train the next generation of physician scientists and basic researchers who are committed to the prevention of disease and health promotion through careers in human Nutrition. Trainees of special interest to this program are 1) physicians who have completed their residency training and whose goal is to develop academic careers as Physician Nutrition Specialists;and 2) basic scientists who are committed to developing research careers in Nutrition, especially those with a major interest in human nutrition who are likely to benefit most from post-doctoral training in the ambience of a major medical center, the Anschutz Medical Campus, which is the world's only completely new education, research and patient care facility. The leadership of the training program, including Program Directors Nancy F. Krebs, MD, and Susan L. Johnson, PhD, has established vigorous post-doctoral training programs that span a broad range of translational research. All training will be in an environment that promotes collaborative, integrative research between physicians and basic scientists, and fosters productive interaction between post-doctoral trainees and 27 faculty preceptors. The program provides outstanding translational research and training opportunities in 3 key areas of Nutrition: Basic Science Nutrition;Human/Clinical;and Nutritional Epidemiology. Associated clinical and public health Nutrition research interests include: Nutrition across the life cycle in North America and in developing countries;diabetes;obesity;liver disease;and cognitive and neurologic function. Affiliations of program faculty are in several departments in the School of Medicine, including Pediatrics (especially the Division of Nutrition), Medicine, and Physiology, and in the Colorado School of Public Health. All faculty are also affiliated with the NIH-supported Colorado Clinical and Translational Sciences Institute and/or the Colorado Nutrition and Obesity Research Center. The training program typically provides 2-3 years of research training and includes formal training in research ethics, research methodology and data analysis. The program directors, steering committee, advisory board, and faculty mentors are committed to actively supporting and guiding trainees in the next steps in their career development. The trainees from this Nutrition training program will be exceptionally well suited to meet the challenges presented by the current paradox of increasing prevalence of chronic diseases impacted by dietary and lifestyle factors co-existing with persisting challenges of nutritional inadequacies.
The research training provided by this program is critical for the development of clinician-scientists in the field of human Nutrition. It also provides an outstanding setting and opportunities for post doctoral fellows to obtain more in-depth training in translational Nutrition science, from bench to bedside to community, and to enable them to become successful independent investigators. NOTE: The criteria scores and the critiques given below were provided by the reviewers assigned to this application. These do not necessarily reflect the positions of the reviewers at the close of the group discussion or the final majority opinion of the group, although the reviewers were asked to amend their criteria scores and critiques if their positions changed during the discussion. Please note that the criteria scores are not averaged in arriving at the final overall impact scores. If the reviewers have not changed their criteria scores after the discussion, those shown in the critiques may reflect the opinion of the reviewers before the meeting. The Resume and other initial sections of the summary statement are the authoritative representations of the final outcome of the group discussion. If there is any discrepancy between the reviewers'commentaries and the priority/impact score on the face page of this summary statement, the priority/impact score should be considered the most accurate representation of the final outcome of the group discussion. CRITIQUE 1: Training Program and Environment: 1 Training Program Director/Principal Investigator (PD/PI): 1 Preceptors/Mentors: 2 Trainees: 3 Training Record: 4 Overall Impact: This application addresses an important need in biomedical research by focusing on human nutrition research training of MDs and PhDs. While billed as an Institutional Training Program in Nutrition offered to all members of the U. Colorado community who benefit from its availability, the primary institutional support appears to come from the Department of Pediatrics;this should be rectified. A strength of the program is the effort to integrate basic nutrition science with clinical science and to extend work beyond the bedside and into the community. Trainees have moved to a variety of positions although their track record of successful research funding is unclear. The leadership team has done an excellent job of sustaining the program in an environment with potential internal competitive training grants and centers/institutes. The interaction with Colorado State University is an asset. 1. Training Program and Environment: Strengths * The present training program has been in existence for 20 years and relocated to a new campus in Aurora, Colorado which provides outstanding state-of-the-art facilities for training programs related to biomedical research. * The leadership should be commended for the smooth transition to the new facility. * Several centers at the University of Colorado, including the Colorado Pediatric Clinical Translational Research Center, the Adult General Clinical Research Center (presumably now called the Clinical and Translational Research Center), and the Nutrition Obesity Research Center as well as the Children's Eating Laboratory are all assets to the training program. * Multiple cores, centers and institutes with excellent resources for the conduct of research. * Opportunities for inter- and multi-disciplinary research and training are ample, provided trainees indeed have access to the mentors and the facilities that are described in the application. * Interaction with the Colorado State University's Department of Food Science and Human Nutrition that has complementary resources. Weaknesses * The research program continues to rely heavily on metabolic research that appears somewhat dated despite excellent clinical laboratory facilities. * Lack of clarity between nutrition research in pediatrics vs. a broader agenda for nutrition in biomedical sciences at the University. * Apparent redundancies in some of the resources available making it unclear as to how trainees decide which unit/core in which Center or Institute should be used. 2. Training Program Director/Principal Investigator (PD/PI): Strengths * Strong commitment of the Program Director to nutrition training with success demonstrated by her obtaining funding for a K24 Career Development Award, her identification as a Physician Nutrition Specialist by the American Society for Nutrition (formerly American Society for Clinical Nutrition) and consistent excellence in teaching awards presented to her over the past decade. * Dr. Susan Johnson has assumed the Associate Directorship in 2009 when Dr. Tracy Horton left the University. Dr. Johnson has taken on more of the responsibilities for administration and should provide expertise in the area of nutrition and behavioral issues as well as facilitating community engagement. * Apparently new for this training grant is an institutional commitment from the Department of Pediatrics and the Children's Hospital to provide funds for administration of the T32 program and this is being used as salary support for the Associate Director at 5% effort. Weaknesses * Lack of clarity regarding whether this is a pediatric nutrition program or a program with broader reach. It appears that the latter is true but the other divisions/centers/departments do not appear to have sufficiently committed resources to enhance and sustain the program although all faculty and students reap the benefits. 3. Preceptors/Mentors: Strengths * The participating faculty members for this T32 include 11 MDs and 16 PhDs with a balance between basic and more clinical translational research. Historical expertise in human and clinical nutrition is continuing with 17 of the faculty involved in this area of research;however, basic animal and cellular as well as epidemiological research is being included with five faculty each. * The base support of external research funding of the principal faculty engaged in mentorship is excellent. Weaknesses * Potential need to expand the repertoire of research areas and methodologies beyond the classic metabolic types of studies would enhance the field of nutrition. 4. Trainees: Strengths * The diversity of the applicants is good having trained at institutions other than the University of Colorado and obviously seeking training for the specific strengths of this program. * The leadership has appropriately recognized that maintaining an applicant acceptance pool of 3 annually would be appropriate for the size of the present training program and the present catchment area that they have. Weaknesses * Opportunity to expand the pool of trainees into other areas of medicine and health sciences would be an important goal for the future, especially when additional resources become available from different centers, departments or institutes. * The recruitment plan has been largely word of mouth and resulted in a stagnant number of applicants over the past five years ranging from four to seven. The applicants appear to be all in the Department of Pediatrics and given the broader nature of this proposal, it may be appropriate to expand the pool of applicants to those who might have trained in other medical or health science fields with an interest in nutrition. 5. Training Record: Strengths * The trainees have moved to positions in academic medicine or nutrition, industry, private practice or public health. * Two trainees have successfully competed for R01s and one for a K01 award. * Attempts to increase this success rate in the present funding climate would be difficult and should be encouraged. * Fair rate of publications by trainees although the table includes abstracts. Weaknesses * Perhaps not a weakness but a challenge is the competition with the other training programs available at U. Colorado, Denver for eligible trainees despite its unique emphasis. * Unclear mechanism for feedback and tracking of graduates of the program. Protections for Human Subjects: Generally Not Applicable Inclusion of Women, Minorities and Children: Generally Not Applicable Vertebrate Animals: Generally Not Applicable Biohazards: Generally Not Applicable Renewal: * Satisfactory progress has been made in the last funding period, but the leadership is encouraged to expand the pool of applicants and to possibly include individuals trained in other areas of medicine or health sciences besides pediatrics. * The interest in global nutrition should facilitate the recruitment of individuals interested in world health and public health and this should indeed expand the pool to enhance diversity. Recruitment and Retention Plan to Enhance Diversity: Acceptable. * The leadership acknowledges that the Program to date has not been as successful in the recruitment and retention of underrepresented minority groups. This, however, is also a challenge for all training programs and health professional schools at the University of Colorado. The proposed strategies to include and act as liaison with the Office of Diversity in the School of Medicine and to more aggressively recruit underrepresented minority applicants appear reasonable. However the benchmarks and time table outlined in the application appear appropriate and should be followed up with an interim progress report to determine the success of these efforts. Training in the Responsible Conduct of Research: Comments on Format (Required): * The plan outlined in the application appears generic for the University and the five instructional components required by the instructions have not been addressed. Comments on Subject Matter (Required): * Not addressed. Comments on Faculty Participation (Required): * Not addressed. Comments on Duration (Required): * Not addressed. Comments on Frequency (Required): * Not addressed. Select Agents: Generally not applicable): Budget and Period of Support: Recommended as requested
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