An Interview with Dr. Clifford Lo
Interview by David H. Xiang
The problem of having access to adequate and sufficient nutrition has always been a persistent public health concern in America, but is now even more prevalent and concerning, given the high rates of malnutrition and obesity in our country.
Dr. Clifford Lo, Associate Professor of Pediatrics at Harvard Medical School, the Director of the Harvard Human Nutrition Program, and Medical Education Coordinator of the Harvard Medical School Division of Nutrition, is one of the leaders in the field of nutrition. In addition to teaching several nutrition courses at Harvard College, Harvard Medical School, and the Harvard School of Public Health, he has also conducted extensive research regarding vitamin D and calcium metabolism, along with parenteral nutrition. David Xiang, Co-Director of Internal Development at HHPR, recently interviewed Dr. Lo about his accomplishments, current work, and advice for people looking to follow in his footsteps.
David Xiang (DX): How did you become interested in public health? Did any event or person or book or moment inspire you?
Clifford Lo (CL): In medical school, I was introduced to infectious diseases and medical history, and I remember reading about Albert Schweitzer, who also had interests in music (an organist and a Bach scholar), theology, and missionary medicine. But also many friends and colleagues continually amaze me, such as Paul Farmer, Yo Yo Ma, Atul Gawande, Jeff Sachs, Nevin Scrimshaw.
DX: How has working in the intersection of medicine and policy changed over the years?
CL: Global health has become much more broad and popular than tropical medicine and international health, its predecessors, and most countries are systematically trying to meet specific goals (Sustainable Development Goals) that improve health, reduce poverty, and provide for a better world. Many private NGOs have joined the UN and World Health Organization in promoting global health.
DX: What notable accomplishments are you most proud of?
CL: Teaching and influencing many thousands of students in many (70 so far) countries, some of whom are already much more famous than me.
DX: What are some public health issues that you are passionate about, and working to address today?
CL: Reduction of childhood mortality has been spectacular in much of the world in the past 50 years, with the infant mortality rate dropping from 200/1000 to as low as 2/1000 in some countries (Japan). Sanitation, clean water, immunizations, and breast feeding have dropped deaths from diarrhea and dehydration, and certain infectious diseases can be eradicated in the next decade.
DX: What has been the hardest thing about working in the field of nutrition? What has been the best thing?
CL: Although I was initially more interested in undernutrition and deficiency diseases, in most countries now the growing problem is of overnutrition and heart disease, which will affect 35-60% of the next generation. Rather than being opposites, they both stem from unhealthy eating habits, and overnutrition will be much harder to treat.
DX: What advice do you have for the next generation of people who are passionate about public health?
CL: Travel and train. Many of the faculty members at HSPH have spent up to 20 years of clinical and academic training often with both MDs, MPHs and PhDs, while being willing to travel at short notice to a new situation for another project. If we can keep up the enormous enthusiasm for another generation, we will see a tremendous improvement in global health.
DX: Assuming you have unlimited power, if you could change one thing about the public health infrastructure in America today, what would it be and why?
CL: Many Americans are individually very generous, but institutionally, the US often lags in doing the best thing for people in other countries. If there were a way to reduce fears about outsiders and try to provide better for others, that would do miracles. One of the most effective ways to improve public health would be to raise taxes on smoking even higher and earmark it for public health research.
DX: What has been the most rewarding thing about your research and work?
CL: I have followed several hundred patients for up to 30 years who have been totally dependent on intravenous artificial nutrition for their survival, but I have also interacted with and taught many hundreds of medical students and dietitians who have had similar roles in caring for patients.
DX: What is your favorite class to teach, and why? What is the hardest, and why?
CL: Twice a year, I teach a small intensive seminar to European medical students who like the American way of teaching in small active discussion groups, learning to ask questions of pediatric patients and their mothers, reasoning out a diagnostic plan, and presenting to their classmates. I’m with them over 50 hours in a week, and have kept in touch with some of them for up to 12 years so far. I also take a group of 40-50 Harvard students to Latin America for a week of medical clinics and public health service like building schools and latrines. I also love lecturing to large classes of up to 350 as well as small groups of undergraduate and graduate students.