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Crystal Ball series

A serendipitous voyage in the field of nutrition and metabolism in health and disease: a translational adventure

European Journal of Clinical Nutrition volume 74, pages 1375–1388 (2020)Cite this article

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Born in the beginning of the Second World War and living in a small village (Hoenderloo, the Netherlands) surrounded by woods, led to a life and play outdoors as a child. My interest in nature was promoted by lack of distraction indoors except the books my mother hired at the library and which were far too adult (in all respects) for my comprehension. Good schools located in a nearby town (Apeldoorn) necessitated at least 25 km biking per day from the age of 9, which I continued doing until retirement at the age of 65 year. After finishing primary school, I attended the Gymnasium in the same town and continued taking an interest in nature and wildlife. Learning that studying forestry in Wageningen did not lead to a ‘life in the woods’, I decided to study medicine, appreciating my father’s joy in being a family doctor. My medical study and specialization thereafter, took 18 years instead of the potential 12 years due to diverting activities in sports, military service, officially non-training activities in surgery in Amsterdam and the USA, but allowed to obtain a broad view on many aspects of medicine (see Table 1).

Table 1 Course through life.
Full size table

My serendipitous journey through life led to learning that Wretlind in Sweden [1] had developed lipid emulsions for intravenous feeding and Stanley Dudrick in the USA, techniques to allow nourishing beagle puppies and babies by intravenous route [2, 3]. In 1970, I applied this technique in a lady with an abdominal catastrophe in a small hospital in Amsterdam, where I acted as resident (not in training) to the combined surgical disciplines. Despite not intending to specialize in surgery, my bosses made an appointment with colleagues in a nearby larger hospital, where I suddenly discovered to be on the way to become a surgeon. There, my interest and practice of dealing with nutritional and metabolic problems started a career in ICU and surgery, becoming licensed in both disciplines. My road through my career went from the hospitals in Amsterdam, via the surgical department in Harvard, Boston, USA (with one of the first nutrition teams in hospitals) to Maastricht, where a multi-disciplinary nutrition team and a surgical metabolic laboratory were established, ultimately also functioning as referral centre for abdominal catastrophies (see Table 1). In the following sections, I will describe the often serendipitously found leads to further research, rather basic in vivo in smaller and larger experimental animals and more clinically in patients. Subjects, focused on, were basic metabolism (amino acids, protein, carbohydrates, insulin resistance and inflammatory conditions), randomized and non-randomized studies in small patient cohorts. The long period of 18 years shown in Table 1 taught me much about focusing, persevering, how to be given authority by co-workers and athletes when challenged, and how to promote positive group interactions. In Boston, I appreciated that surgeons could be interested in basic metabolic problems and for that purpose could run laboratories addressing these problems. In addition, I learnt that our surgical abilities allowed us to perform in vivo research by creating animal models in stress or after trauma and allowing transorgan assessment of substrate exchange. This was even more facilitated by employing techniques, using stable isotopes. As intensivist, surgeon and having access to sophisticated techniques in patients and experimental animals, our research could address aspects of metabolism that were often derived from clinical observations as starting point, intrinsically including translation.

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Acknowledgements

I first want to acknowledge the contribution of my parents, who never disputed my decisions or the protracted course between leaving secondary school and becoming a licensed surgeon. They inspired me with confidence in myself. Fate has been benevolent to me offering a large number of accidental successive opportunities, without which my career could not have evolved in the way it did. Its backside was that my family had to put up with a father and husband, very often with his head in the clouds of patient care and of why reacts the body the way it does? My first actions in the surgical disciplines must have appeared adequate, so that my boss in the first small Amsterdam hospital, the late Henk van der Reijden pushed me into a training position in surgery in a larger hospital. One of the bosses in that hospital, the late Co Greep was appointed professor of surgery and one of the seven founders of the new medical faculty in Maastricht in 1974 and took with him three surgical residents, including me and one just licensed surgeon. A decade earlier, he had completed a 3-year training residency in Harvard University in Boston, USA during the Vietnam war, because the Massachusetts General Hospital was short in surgical residents that had to enlist in active military service in Vietnam in view of the numerous casualties of American soldiers. He therefore had easy access to the surgeons in Boston allowing us to be introduced and become clinical fellows in surgery and research, even receiving modest salaries. In Maastricht, there was no previous academic activity, so that everything proposed was welcome and money was available. Simultaneously, Foppe ten Hoor, a biologist and nutritionist was attracted as head of the department of Human Biology in the Biosciences part of the faculty. He realized that collaboration with the clinical departments would boost activities in this field. This started a fruitful collaboration, later leading to NUTRIM, the School of Nutrition and Translational Research in Metabolism. In the paper, I mentioned a number of names that have been important in the development of the field and my career. I want to add the nurses and dietitians in the nutrition team (Margriet Rouflart, Esther van den Hoogen), technicians in the laboratory (Hans van Eyk, Mieke Janssen), and colleagues (Maarten von Meyenfeldt, Jan Willem Greve, Wim van Gemert, René van der Hulst, Kees Dejong, Steven Olde Damink) and PhD students, some of which devised new studies following evolving themes deepening insight in metabolism in specific disease states. The collaboration with the department of Human Biology (Klaas Westerterp, Wim Saris) allowed to develop and use advanced techniques (body composition, tracer methodology, energy metabolism) that greatly facilitated and improved our research, for which I am grateful.

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    Peter B. Soeters

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Soeters, P.B. A serendipitous voyage in the field of nutrition and metabolism in health and disease: a translational adventure. Eur J Clin Nutr 74, 1375–1388 (2020). https://doi.org/10.1038/s41430-020-0584-9

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