Still searching

Former Pennington director enthusiastic about obesity research

“Lots of people retire before my age. ... I want to work forever. I can call my own shots and write my own grants.” Dr. GEORGE BRAY

Dr. George Bray, researcher of international renown, is 80, will turn 81 this month and has the outlook of a man just setting out on his life’s path.

Bray, who served as the first executive director of Pennington Biomedical Research Center and is now a Boyd professor, LSU’s highest professorial rank, said that he’s still deciding what he wants to be when he grows up.

In the meantime, he’s one of the country’s foremost researchers in the study of obesity.

Bray was one of a handful of researchers who pioneered study in the field 50 years ago — at a time when the word “obesity” wasn’t in the day-to-day lexicon.

“Far fewer people were interested in it and working on it,” said Bray, who is chief of Pennington’s Division of Clinical Obesity and Metabolism.

Research that Bray and his colleagues at Pennington and other research centers have been involved in is now part of everyday life, in particular that of the DASH (Dietary Approaches to Stop Hypertension) studies, which produced an eating plan that’s now part of the U. S. Department of Agriculture’s dietary guidelines.

The eating plan “did about as good as any blood pressure medicine,” Bray said.

The DASH eating plan, which can be found at http://www.dashdiet.org, is low in fat and emphasizes fruits, vegetables and fat-free or low-fat dairy products.

Throughout the 10 years Bray headed Pennington — from 1989 to 1999 — before stepping down as executive director, Bray continued his research and he has no intention of stopping. “Ten years is enough. I don’t think we should have department heads and deans” for longer than that, he said.

“Lots of people retire before my age,” Bray said. When they do, his inevitable thought, he said, is “‘I don’t want to do that!’ I still don’t want to do that. I want to work forever. I can call my own shots and write my own grants.”

It seems to be an outlook shared by Bray’s fellow 1957 graduates of Harvard Medical School, a school with an emphasis on research, Bray said.

At his recent, 55th reunion this year at Harvard, Bray noted that of the approximately 40 of his peers who provided information on what they’re up to these days, “about half are working, most of them full-time.”

Since 2008, Bray has generated nearly $10 million in research funding, according to Pennington, and has a grant application under review for continued diabetes-prevention related research.

“You’ve got to have original ideas. That’s the key element,” Bray said of securing research funding.

“We’re an entrepreneurial research institute,” he said of Pennington. “If you want to stay here, you’ve got to get research grants. You need to be able to compete for the research dollars.”

Regularly traveling the globe for research-related work and conferences, Bray splits his time between Baton Rouge and San Francisco — the Brays lived many years in California — where he and his wife, Marilyn “Mitzi” have a blended family that numbers eight grown children and 16 grandchildren.

For years, Bray made the trip between here and there weekly, but “as computers have gotten better,” he usually makes the trip to San Francisco every other week, he said.

After speaking with an Advocate reporter in late June, Bray was looking ahead to immediate travel to Washington, D.C., to meet with the Food and Drug Administration and then to Canada’s Quebec City, for work regarding abdominal obesity.

He said his wife teases him that “the only thing that’s happened since you’ve gotten in the field (of obesity) is, it’s gotten worse.”

He responds, “More for me to do! I haven’t solved the problem yet.”

Bray was born in Waukegan, Ill., north of Chicago, to parents who valued education. His father, George Bray Sr., who worked for a telephone company, had a graduate degree in economics. His mother, Mary Bray, had a graduate degree in home economics and, when her son was out of college, received a master’s degree in fine arts from the Art Institute of Chicago.

George Bray Jr., who earned his undergraduate degree in chemistry from Brown University in Providence, R.I., said that “in high school, I decided I wanted to be a doctor.”

It was in the years following his graduation from Harvard Medical School, in 1957, that Bray found his field of research.

Following the genetics trail

In a short number of years, following Harvard, Bray was a research associate for the National Institutes of Health, then took up clinical work in internal medicine at the University of Rochester Strong Memorial Hospital in Rochester, N. Y.

There, Bray began training in endocrinology, the study of the medical aspect of hormones, before a year spent at the National Institute of Medical Research in London.

He returned to the U.S. and completed his training in endocrinology at Tufts New England Medical Center in Boston.

And it was there that a mentor launched Bray on his research path, providing him with a type of laboratory rat that was naturally obese and asking him what the genetic basis for the condition might be.

“This launched me on what has been my pursuit, since then, of trying to understand, at both the laboratory bench and in the clinic, how obesity develops and what we can do about this,” Bray wrote for a biographical sketch called for in his research work.

“It’s a highly genetically transmitted trait,” Bray said of obesity.

“It’s carried in a large number (of genes), 30 or so. Each plays a small part. If you have 15 or 17 of them, you’ll weigh 8 to 10 pounds more” than the person who doesn’t, he said.

“The genes interact with your food intake and other activities,” he said.

“Environment is also very strong,” Bray said.

Perhaps nowhere is that more evident than in countries, which, at different times in history, have experienced famine, he said.

“Obesity and diabetes largely disappear,” Bray said.

Fellow researcher Barbara Hansen, Ph.D., a professor of internal medicine and pediatrics at the University of South Florida College of Medicine, has collaborated on research with Bray and their colleagues across the country for more than 25 years, she said.

“He has been a leader in obesity research since before it became popular,” Hansen said of Bray.

“The world out there believed obesity was just bad behavior and gluttony,” she said. “Now we know it has a genetic, physiological factor. Environment can restrain it, but not cause it.”

“Unfortunately, it isn’t very politically correct to say what I’m saying. People out there want to blame the patient. Essentially, they’re saying, ‘You did it to yourself and you can fix it,’” Hansen said.

But, they’re wrong, she said.

“It’s very difficult to lose weight and keep it off,” said Hansen, who co-edited with Bray a book published in 2008, “Metabolic Syndrome: Its Epidemiology, Clinical Treatment and Mechanism.”

On the West Coast

In the 1970s and 1980s, Bray worked in California as an associate professor of medicine at the UCLA School of Medicine in Los Angeles, where he later became a professor.

During the same years, he was also associated with the Harbor-UCLA Medical Center in Torrance, where he served, for overlapping years, first as the director of clinical research, then as the associate chief of endocrinology.

Later, before coming to Pennington, Bray was with the University of Southern California Medical Center in Los Angeles, as the chief of diabetes and clinical nutrition, as well as a professor with the university, from 1981 to 1989.

Though Bray had been working in the field of obesity research for more than a decade by 1970, that was the year, he said, that research funded by the National Institutes of Health established what the major public health risks were at the time.

“The first one was diabetes; the second one was obesity,” he said.

During his years in Los Angeles, Bray founded the North American Association for the Study of Obesity, now The Obesity Society, and was the founding editor of its journal, “Obesity Research.”

It was in Los Angeles that Bray, a trim man, purposely gained weight for research.

“I figured if I was going to ask people to gain weight (in clinical trials), I would do it,” Bray said.

At the age of 43, he went from 165 pounds to 195 pounds in eight weeks: “At every meal, I ate a bunch,” he said.

“It made me feel awful,” he added. His clothes didn’t fit, and he felt warmer than usual, he remembers.

He went back to his regular eating patterns and returned to his original weight, where he remains.

Perhaps he’s got the good genes; Bray credits outdoor activity with helping him stay the same weight he was at in the 1970s, but finds that easier to do in the climate of California, he said.

Studies of a career

In addition to the (DASH) study, Bray named two other studies he’s been involved in that he feels are particularly significant.

Initiated in 1993, in 22 centers across the U.S., including Pennington, the Diabetes Prevention Program Outcomes Study compared an intensive lifestyle program, incorporating weight loss and increased physical activity, to the medicine metformin in preventing Type 2 diabetes.

“By 2002, we had clearly already proven what we wanted to prove,” Bray said.

What the research proved was that the intensive lifestyle program outperformed the medicine.

“It reduces conversion to diabetes 60 percent of the time,” Bray said.

The trial is continuing and, now, the intensive lifestyle program is being offered to all of the study volunteers, he said.

Researchers are looking for ways to reach the community at large with intensive lifestyle programs.

Bray presented a paper in Philadelphia in June to the American Diabetes Association, he said, on implementing on a large scale, through the YMCA, physician-referred lifestyle programs for people in the community.

Another study Bray names, the LOOK Ahead Trial, is a 16-center study, under way for more than 10 years now and still in progress, that is researching whether an intensive weight-loss intervention for people with Type 2 diabetes will have an effect on the incidence of “time to incidence” for major cardiovascular events, according to Pennington literature.

Bray said there’s already been one significant benefit for the people in the trial: increased mobility.

“People who lost weight were more mobile,” he said. “One predictor of bad health and institutionalization in the elderly is mobility.”

Summing up the three trials mentioned here, Bray said, “Those are the major research trials that have kept me out of trouble.”

Dr. Donna Ryan, who retired recently as Pennington’s associate executive director for clinical research, has known Bray for a long time.

“I was actually assigned to pick him up at the airport for his first interview” in 1988, remembered Ryan, who does consulting work for drug and device technology for obesity, and co-chairs the panel that is revising the obesity guidelines for the NIH.

“George is first and foremost a scholar. He’s written thousands of papers and countless books. It’s very unusual to find someone with that scholarly background so congenial and fun-loving,” Ryan said.

She credits him for helping her and many others, along in their research careers.

“He’s a great mentor,” Ryan said.

During his career, Bray said, research has been changed by such advances in technology as the imaging equipment and use of tracer isotopes, the use of nonradioactive isotopes mixed with water to discern a person’s food intake. “We know that people under-report ... people are not very good at keeping detailed records,” he said.

Pennington, for instance, also has metabolic chambers, small rooms that study participants can live, in which their metabolic rates can be measured.

“They were not widely used until the 1980s,” Bray said of the chambers.

“Now, they’ve become very valuable tools. Me and Mr. Ravussin fight over them,” Bray joked, referring to his colleague Dr. Eric Ravussin, Pennington’s chief of the Division of Health and Performance Enhancement and a fellow Boyd professor.

“If you’re going to remain active in research, the questions and methods have to change,” he said.