View  Transcript

Today on The Fundamentals, our guest is Dr. Julie Lumeng, the associate dean for research at the University of Michigan Medical School, executive director of the Michigan Institute for Clinical and Health Research, and the associate vice president for Clinical and Human Subjects Research for the university. She's also a professor in the departments of pediatrics and nutritional sciences, providing leadership on the strategic vision of the medical school's office of research, as well as running her own research lab focused on applying emerging science in child development and behavior to the prevention and treatment of childhood obesity. 

You can learn more about Dr. Lumeng here, and you can follow the Dr. Lumeng @JulieLumeng and the Michigan Institute for Clinical and Health Research (MICHR) @UM_MICHR on Twitter.

Resources

• Find out more about the research stories mentioned at the top of the show at the links below:
  • Mapping the brain stem’s control of eating could lead to better treatments for obesity
    An atlas of neuronal circuits could help predict targets for medications to control appetite
  • The feeling of hunger itself may slow aging in flies
    Research examines changes in the brain that prompt the drive to seek food
• You can learn more about The Fundamentals on our website.
• Learn more about other exciting research happening at the University of Michigan, by checking out Health Lab, Michigan Medicine's daily online publication featuring news and stories about the future of healthcare.

Transcript

Kelly Malcom:

Welcome to The Fundamentals, a podcast focused on the incredible research and researchers here at Michigan Medicine. I'm your host, Kelly Malcom.

Jordan Goebig:

And I am Jordan Goebig, and I am very excited about this week's episode. Our guest has such a prolific research career at Michigan, and I feel like I learned so much about the direction of where research is heading. Spoiler alert, lots of really cool things happening to make research a more efficient and inclusive place.

Kelly Malcom:

Yes, I was encouraged by this interview as well. The way people do research has come a long way and can go even further still.

Jordan Goebig:

In this week's article, I found a Kelly Malcom original about how an atlas of neuronal circuits could help predict targets for medications to control appetite. Given our guests’, decades-long research portfolio in childhood obesity, I thought this was a fitting piece to highlight.

Kelly Malcom:

And speaking of appetite, a study I found interesting, centered on research in fruit flies, which found that the feeling of hunger itself may slow aging.

Jordan Goebig:

As usual, we'll provide links to the full articles and info about our featured guest in the show notes. Now, let's get onto our guest.

Kelly Malcom:

Today's guest is Dr. Julie Lumeng, the associate dean for research at the University of Michigan Medical School, executive director of the Michigan Institute for Clinical and Health Research, and the associate vice president for Clinical and Human Subjects Research for the university. She's also a professor in the departments of pediatrics and nutritional sciences, providing leadership on the strategic vision of the medical school's office of research, as well as running her own research lab focused on applying emerging science in child development and behavior to the prevention and treatment of childhood obesity. Welcome, Dr. Lumeng. It's a pleasure to have you here today.

Dr. Julie Lumeng:

Thank you so much for having me.

Jordan Goebig:

Yes, welcome to the podcast. I'm really looking forward to learning more about your work. So let's dive right in and get down to it. I'd love to hear more about what led you down this path to studying childhood obesity in your lab.

Dr. Julie Lumeng:

Yeah, great question. I think as I've gotten older, I've come to realize that we're all a product of our times and childhood obesity was the epidemic that everyone was really focused on. It was what parents and people in the community were most concerned about back when I was a young researcher. And so I was training in pediatrics and it was sort of in the zeitgeist that everyone was really worried about childhood obesity, sort of like the emphasis now on children's exposure to digital media and iPads and gun violence is so prominent now, so that was why. And then I think, also, I was seeing a lot of kids in clinic as a pediatrician in training who were struggling with obesity. And when I was a kid growing up, there was obesity in my family and there's still obesity in my family. So it was just familiar to me as an issue, and I think I had empathy for it, so that was why really.

Jordan Goebig:

Yeah, it was a hot issue at the time, but it is a really important issue and still one that many families are facing. So it's much appreciated that you do have this longevity in this field. So we are The Fundamentals. A lot of times I ask individuals to define a term or a concept, but I thought it might be important to focus on common misconceptions about childhood obesity instead and how your research has contributed to knowledge on that subject.

Dr. Julie Lumeng:

So in medicine, it's a well-known issue that when medicine doesn't understand something, we tend to blame it on personal responsibility or when it's a childhood issue, we blame it on the parents and we consider it to be a result of bad parenting. And I think that childhood obesity 20 years ago was really falling victim to that, that there was a big emphasis that if only we could teach parents, and it generally was mothers, if only we could teach parents, and generally it mothers, if only we could teach mothers how to parent better around childhood obesity, then children would not be obese. And it wasn't true then, and it's not true now. And I think what researchers have really come to appreciate over the last 20 years is that it's just biology. There is so much biology and yes, of course, our food environment has changed. That is absolutely true, but it's like a biology and environment interaction because if it was all the food environment, everyone would be obese, but everyone is not obese.

And so if you have the right biology and you live in today's environment, that combination is going to put you really at risk. And so my research program, we initially started out thinking a lot about children's behavior and the idea that sometimes people think of children as a blank slate and that the way children turn out is all a direct result of how they were parented. But children come with their own profile. And I think just like kids have their own temperament and personality, they really also have their own eating behaviors. And as a parent, you get what you get and you parent around, is your child a picky eater? Are they a voracious eater? And so we were spending a lot of time thinking about that. And I think as I've grown as a researcher over time and had more collaborations, I've been thinking a lot more about the biology behind all of it. And so we've been thinking about stress hormones and oxytocin, the bonding hormone, and how does that all relate to eating behavior and obesity?

Kelly Malcom:

Yeah. And so I know that I said a lot of different titles in your intro and I'm so impressed by you and I wonder what it's like transferring some of your skills as a researcher to administrative roles. And what role has your work as a researcher played in you now holding these leadership roles in research at the medical school?

Dr. Julie Lumeng:

So when I first started in my career as a young person, I was a pediatrician and I came from a family background that you went to college to have a trade and my trade was going to be becoming a physician. And I went through all my clinical training and then becoming a researcher was just nowhere on my radar screen. No one in my family had a PhD. No one in my family had an MD either, but that just seemed more accessible. And so once I finished my clinical training, I was exposed to research and I just really, really loved it. It was one of these things that I found myself jumping out of bed in the morning to go to work. I enjoyed being a clinician, but I think I really recognized that research was really what I was most excited about. All that being said, I think that my clinical training is fundamental to the kind of researcher I am, and I think it's fundamental to being an administrator.

And I don't want to wax too philosophical about it, but people often have reflected that being a physician is probably the only profession where it is just accepted that you can walk into a room and within three minutes start asking people their most personal and intimate questions. And physicians are trusted to do that. And I think that part of being a physician is that you learn to build rapport with people really quickly. And I think that because you hear so much about people's really most personal issues, I think you just develop a lot of empathy for people and understanding that everyone's walking into the room with their own perspective and their own background.

And I guess I think, again, not to wax too philosophical, but I think the most fundamental part of being an administrator is to be able to see the different perspectives in the room and have empathy for all of them and understand that when there are two different opinions at the table, there are multiple ways to try to solve that issue, but you're probably not going to change people's perspectives, so you just have to figure out how to make this work to help everyone move forward together.

So I've been at the University of Michigan since 1991 when I came here as an undergrad, I left for a few years, but then came right back. I've worked as a physician in the healthcare system and I've been a student here, I've been a trainee here. And then I've been a researcher who's worked with people at the medical school and on central campus. And so I've had exposure to all those perspectives. And I guess, I think all those people, they're really awesome people. The physicians are amazing people who I have so much respect for what they do and how passionate they are about what they do. And the researchers on central campus and at the medical school, they're amazing. We're so lucky to have them. And so I think in order to be an effective administrator, you really have to like the people that you're advocating for. And I just really genuinely like all these people. So I'll stop digressing on that.

Kelly Malcom:

Well, that's wonderful. We've really enjoyed everyone that we've spoken to so far on the podcast, so we definitely concur with you there. So recently, the Michigan Institute for Clinical and Health Research, which we call MICHR, was awarded a large grant from the NIH's Clinical and Translational Science Awards program. Can you explain for our listeners what that means? So it's the CTSA, what CTSA's are and why U of M's participation in this program is so important.

Dr. Julie Lumeng:

Yes, and so the CTSA program was started by the National Institutes of Health back in 2006, and it was started back then because appropriately members of the public were frustrated that their taxpayer dollars at NIH were not being translated into things that they were seeing an impact in the community or with new medications or devices or that sort of thing. And so the NIH said, "Okay, we're going to invest resources in helping these academic medical centers and universities around the nation really build up their infrastructure in order to be able to do clinical and translational research more efficiently." So we're lucky because the University of Michigan was one of the 60 institutions around the nation that was chosen back at that time to be a part of this program around the nation. And we're all very networked and we work together and communicate with our peer institutions around the nation. And we've been renewed ever since then because it goes in five year cycles.

So most recently, however, the NIH said, "Okay, for the last 15, 20 years, we have been investing in building up this infrastructure around the nation. We think the infrastructure has really been nicely built up now. Now, you 60 institutions, we want you to try to study, like it's a research topic, like the science of science. Now that you have this infrastructure, what are the most important components of that infrastructure that make research happen more efficiently, with higher quality, with more innovation, faster?" And one of the things we often cite is that it takes 10 to 15 years for a drug to make it from working in the lab with molecules to bringing it to market. And of all of those drugs, only 5% of them actually make it all the way to market, and it costs billions of dollars. And the question is, can we use our research skills as researchers studying diabetes or heart disease or whatnot to actually research that process? Is there a way to make that process more efficient and go faster so that we can find either cures or strategies for prevention more efficiently?

Jordan Goebig:

As you dive into the process of research, do you have any examples of how research has changed over the past couple of decades that you've seen and maybe even a reflection on where you're hoping that it could go?

Dr. Julie Lumeng:

Yeah, so I think a few ways that it's changed. It's changed a lot, number one, but a few ways that it's changed, first of all, I think everyone would agree, there are a lot more regulations around research than there used to be, and people see it from both sides. But I think it's appropriate, the purpose of the regulations is to make sure that it's done correctly and appropriately and that we get the best and highest quality data and that any people who are participating in it are having a really good experience participating. So the regulations have become greater. I think the other thing that is interesting that's really grown a lot even in the last five years is the expectation for transparency. And so the NIH has been mandating this and researchers themselves have been coming forth voluntarily to do this.

The issue is decades ago there would be problems that you would do a study and if it didn't have interesting results, it wouldn't get published. But then unfortunately, probably 10 other researchers would do the same study and not get interesting results and not publish it. And that's just a waste of resources. And it's an example of if we could do that better, we'd probably get the science done faster instead of research going into a black hole. So there's been an emphasis on transparency and making sure that data and results are made available to other researchers in the public more easily. I think there's that. I think another thing that's changed a lot recently is social media and Twitter. It used to be that researchers would learn about other research topics by reading medical journals or research journals. And now the biggest predictor of how frequently a new research finding will get cited and built upon is how much it was tweeted. And so scientists are really communicating a lot on Twitter. And so social media is important.

And then the last thing I would say because I think it's non-ignorable, is that women and more diverse populations are now in the research workforce more. And I think we're all aware that historically topics in women's health have gotten less funding, and I think that now that women are more frequently members of higher administration or full professors at universities, I think topics that maybe women have lived experience in, maybe like feeding children, the topic I study, I think that a lot of those topics have been neglected over the years. And now that women are doing that research, I think they're getting a lot more attention. And so the topics we study, I think, are evolving as well.

Jordan Goebig:

This is exciting. Thank you. There's a lot of work to be done, but it sounds like there's a lot of opportunities that we have the right people working on. So this is an exciting time to be a part of research.

Dr. Julie Lumeng:

I agree.

Kelly Malcom:

I think the pandemic made the scientific process a little bit more visible to the general public in a way that maybe it wasn't before. And I personally as a science communicator would love to see that continue. What do you think some of our researchers should do to make science more visible to the people that they're doing the work for? What are some of the steps they could take?

Dr. Julie Lumeng:

Yeah, so I think in some sense social media is the great equalizer because it gives everybody a platform to comment. We could argue is that good or bad, but I think there are a lot of people who on Twitter have really gained a lot of prominence and have a really valid, valuable perspective on things, and they gain a lot of followers. And I learn a lot from people I follow on Twitter about different topics that I may otherwise not have had access to. So I think number one, in terms of the studies when we design them, there is a big emphasis now and it is correct and appropriate, and we never should have been doing it this way. Historically, topics would be studied and the people who were living the topic were not involved in the study.

And I want to be gentle when I say this, but in my own experience, it's like child feeding. The topic I study is how do infants eat? And when you look at that research literature dating back to the 1930s, the researchers, they were men and the pediatricians, they were men, and they made such important contributions and laid this awesome foundation of research, but it was a small research literature and there wasn't a whole lot there. And then not a whole lot happened. And then you would see in the eighties and nineties, we started to get more women in research and women who had breastfed, they're going to have intimate knowledge of how do babies eat exactly? What is the sucking like? When do the babies slow down their sucking? How can you interpret a hunger cry in a baby? Who better to research that than a woman who has had to feed a baby 24/7 for months?

I think it's so important that when we're studying things that the people who live it, whether it is something in daily life like feeding a child or it's a disease process, like a condition that people have, I think there's no better person to be a part of the research team than someone who's actually experiencing the condition. So the NIH is emphasizing a lot right now and actually sometimes mandating that when you have a research study that you have a, what they might refer to as a community member, as a full member of the research team, not just someone that's consulting, but someone who's actually sitting in with the team on the standing meetings and contributing to the design and the interpretation and all of that.

So maybe I should mention that because that's so important, one of the things that MICHR the Michigan Institute for Clinical and Health Research is doing going forward in the next seven years is we're launching a program that's called Patients as Partners, where we're collaborating with someone named Greg Merritt, who is this fabulous person, who has been a patient here at Michigan Medicine, and he's transformed that experience into really advocating for patients being a part of the study team. And he's amazing if you ever listen to him talk.

So we're partnering with him to think about how can you give patients or community members the training and skills necessary to make the most of that experience. So instead of just inviting a patient to be a member of a study team, we're going to partner with him to develop a program, perhaps it's like a half day retreat sort of thing, where you invite patients to come together and then we basically discuss for the afternoon, how can you make the most of your experience on a research team and really contribute?

Kelly Malcom:

I think that's probably the first step is to have the people who are going to be most impacted involved in this study from the beginning. But how do we also just make sure that everyone gets access to the fruits of the research process?

Dr. Julie Lumeng:

And so this is really important to talk about as well, because we think about research, the science of research or the science of science in stages of translation. And so we think about five different stages and the earliest stages like molecules, and then the latest stage, which we refer to as T4, T5, depending on who you talk to, if there's been a drug that's been discovered to be really effective, how do you get that out into the hands of patients? And part of that is ensuring that physicians are prescribing it, are aware of the drug and how to use it and how to prescribe it, and then also in the public how to get the public to take up an intervention. And that might be an obesity prevention strategy or something like that.

And so I think circling back to what I was saying before, the public over the last 30 years really appropriately has advocated to NIH to say our taxpayer dollars are going into research. And we want to see that not only are there these new basic science discoveries, but that those get translated into applied interventions that we can see have an impact in the community. And so one of the things that MICHR, the CTSA program, is tasked with doing is how do we make that happen more effectively? So we're partnering with some people at the university. Amy Kilbourne, for example, is one of our experts here in implementation science and implementation sciences, this whole field of the science of how do you get these discoveries implemented? So there are quite a few people here who are researching that, and we'll be partnering with them to see how we can do it better.

Jordan Goebig:

I feel like we've talked a lot about some specific projects that you have going on at MICHR. Are there any other ones that maybe you're personally pursuing in your lab? I would love to hear about it. I think that I've probably talked about my kid throughout this podcast more than anything, proud new-ish mom. But I would love to just hear more about your research, if you have any specific projects through your lab, through the med school, continue to plug MICHR because it sounds like you've got some amazing things there, but anything you wanted to talk about?

Dr. Julie Lumeng:

Yeah, so I guess two things. One, so there's one other MICHR program that I think it's really worth highlighting, and then I can talk a little bit about my research as well. So we're starting this new program with Susan Murphy, who's one of our professors here in physical medicine and rehab. So this program, it's called the Behavioral Research Innovation and Support program. And the premise of this is that historically the CTSA program was really focused a lot on drug and device research, which is great because someday if I have a disease, I want there to be a drug that I can use. So we will continue to do that, and it is so important. It's also true that there are a lot of things in people's wellbeing and community health that are related to behavior. And so historically, there's been less emphasis, I would say, both at universities and at the NIH on behavioral research and helping those researchers bring the same innovation and rigor and quality to their work that some of the drug and device trials have.

And so Susan has actually been a national leader in that space. She's sat on NIH committees and helped the NIH develop a lot of their tools for that. And so we're so lucky to have her here, so she's going to be leading our work in that space. And I should say that of the trials that our faculty here at the University of Michigan propose on their own, the ones that they create, half of them are behavioral, so they're not all drug and device. And so because half of them are, and according to the federal data of all of the behavioral trials in the state of Michigan, the University of Michigan leads like 60% or 70% of them. So from that perspective, we felt that we really have a responsibility to do what we can to create an infrastructure to support that. And so we'll be working on that for the coming years.

But going back to-

Jordan Goebig:

But you're still finding time to do everything in your lab.

Dr. Julie Lumeng:

Somehow. Yeah, so I'm really excited about this project that we're starting next. So I've studied parenting behavior and child eating behavior from a behavioral perspective, and we spent a lot of time interviewing moms and seeing what their perspective is on feeding. And I've been doing that for a long time, but I also have training as a physician, and so I understand the physiology of hunger cues and satiety cues and stomach emptying and glucose and all of this. And I just got to a point where I thought, "I think I have an obligation to integrate that knowledge because there are probably not that many people in a position to be able to do that." And so this project that we're starting now, I'm pretty excited about.

So there are a lot of different little studies out there that have been going on for 30 years that we just haven't integrated this into one big study. And so for example, so there's this classic study out there that shows that babies will learn to recognize a face more if they're shown that face while tasting something sweet. And so I think it's fascinating because if Mother Nature were going to design a mechanism for babies to recognize their mother's faces, you would make that recognition be promoted by the baby being fed at the same time.

So here's another little snippet. So oxytocin, which it's in the public sphere, people have been talking about this a lot now, but oxytocin is like the bonding hormone, but oxytocin also is related to hunger and satiety. So the more oxytocin you have, the more it suppresses your appetite and makes you feel full. So the question is, a lot of times in the public, you hear a lot that people are saying, "Don't mix food and love. Keep those two things separate. It's so important not to think of food as love." And the argument I'm making is, you know what? In very early infancy, food, and if we consider love to be like mother child attachment, mother child bonding, those two things are inextricably linked.

Yes, exactly. And you know what? I think this is coming full circle because I would say if you're a mom who has had the lived experience of feeding a baby for hours and hours, I think that idea that feeding a baby is not like changing a diaper. It's not a task. There's a whole lot of other biology that I think goes on in a mother's brain. There's another really interesting study that shows that when a baby cries, for women in the first few months postpartum, the parts of their brain that light up are the parts of their brain on an FMRI that are much more about emotion and much more similar to obsessive compulsive behaviors. And if you do the father's brain, the part of the father's brain that lights up when a baby cries is just the practical problem solving part.

And so I often say that when my babies were really young, when they cried, it really stressed me out. And my husband, who's also a pediatrician, I knew that research literature and we would talk about it and we were able to self-reflect as a couple that it just didn't stress him out as much. And I think that it's biology. It's not that there was anything wrong with me, it was that the hormones in my brain were causing me to have that reaction to my baby crying, which when you think about it once again, if Mother Nature were going to design something to make sure that babies survived, they're going to design it so that when mothers hear their baby cry, it elicits this big brain response that's not ignorable. To bring this full circle, there are a lot of researchers who think that maybe one of the reasons that some children develop obesity by the time they're two years old is that maybe mothers are using food too much to soothe a crying baby, and that we need to create interventions to teach mothers not to use food to soothe the crying baby.

And there are some fabulous researchers who are my colleagues in the research community who have done really important work that they have demonstrated that if you work with mothers to provide them strategies for how to soothe the baby in a way that doesn't involve food, that that does change the growth pattern of the baby in a healthy way. The effect is really, really tiny in my opinion. And I guess what I want to say is that it's great to give mothers alternative strategies for how to soothe a crying baby, absolutely. But I will say that having had three babies myself, there were definitely many times that the only thing that would soothe my baby was feeding my baby. And when that would happen, the question was, was my baby really hungry? What does hunger even mean? If hunger is needing calories, I think that there were times that my babies were crying really vigorously to be fed, and I would think, "I don't think you need calories right now." But there was nothing else that would soothe them. And so I would feed them.

And it's true that sweet taste releases opioids in the brain and anyone who's ever breastfed, you feed that baby and all of a sudden they just calm so dramatically. And if doing that promotes mother infant bonding, if the baby learns that when they cry to be fed, their mother responds and feeds them, and then that releases opioids in the baby's brain and the sweet taste helps them recognize the mother's face more, should we really intercept that and stop it to say, "Oh, don't want to promote childhood obesity, so don't feed your baby?" I just think we're walking in really dangerous territory unless we really understand that system. That's the project we're starting now, and we'll be recruiting people, inviting mothers to participate to help us understand how feeding and mother infant bonding relate to each other.

Jordan Goebig:

No, this is wonderful. I'm excited, again, as a mom to read this. But it also just sounds like you're coming from this place of literally as a researcher wanting to give parents the best or better tools or more tools in their toolbox to feel good about what they're doing, which is, again, the most important thing. And I also would just feed my baby.

Dr. Julie Lumeng:

Exactly.

Kelly Malcom:

It's the easiest thing to do, honestly, and I don't really feel like parents should feel guilty about wanting to soothe their child. And I feel like your research is really relevant and speaks to so many parents because they're always in this state of, I just want to do the best thing for my child and I'm not really sure what to do because I get so many mixed messages and combining all of your research together to say, "This is what we found. This is what's happening on a biological level." It might make it easier to make those decisions and feel less bad about them or less uncertain about them, so that's fantastic.

Jordan Goebig:

Yeah, I have a rising toddler, and so it's less about those... She's not taking a bottle anymore, but as a working parent, my only time I spend with her is usually meal times. And so you're right, sometimes I get in my own head about does she just associate the time I care for her with food? But at the same time, we have really truly lovely meals together and fun, and I'm not actually concerned, but I can get in my own head about it. But then I realize that it's just a really lovely time for my husband, myself, and I to bond with her. And mealtime is important for us. We still sit around and she will go to her high chair by 5:30 if we haven't fed her and sat down, she will let us know. And we're having a good time.

Kelly Malcom:

And I think a lot of cultures around the world involve food as part of expressing love and showing kinship and all of that. And I saw a research study in JAMA that was talking about the longer a child sits at the table, the more fruits and vegetables they eat or something, for every 10 minutes.

Dr. Julie Lumeng:

I could imagine that.

Kelly Malcom:

The more fruits and vegetables they eat. So I think it's really fascinating that whole interplay between your biology and your behavior. And it's great that U of M is focusing, what is it, half of their studies on behavioral research. So I did want to ask you for our listeners who are researchers who might be approaching designing their study, do you have any advice for researchers who are just now starting out in doing translational or clinical research?

Dr. Julie Lumeng:

Well, I guess my biggest piece of advice is that to reach out for help and ask for help. And so MICHR is here to help the researchers, and we have a lot of mentoring and training and support programs, but even for people who are already done with their training, we all continue to need mentoring and support. And so my number one piece of advice is reach out to MICHR and we can help you navigate the university's system to get the support that you need. And we do also have context around the nation to help connect you to different resources. I guess outside of MICHR, I would always say you need to be comfortable admitting what you don't know and being honest when you need help and asking for it because I'll say sitting in a lot of administration meetings all day long at the university, man, administrators really want to see our researchers succeed and they think our researchers are really great people and they're here to facilitate and to help and to make the research happen.

People, even in the regulatory compliance space, where their whole job is to make sure that things get done correctly according to the rules, I'm so proud to work with them because when you hear them talk about our researchers, they are allied with our researchers and they are doing everything they can to help that great work happen. And so maybe that's my other suggestion is that if you're a researcher and the people who are responsible for enforcing the rules reach out to you, they're your partners and so not to feel like it's a struggle that you have to try to operate around these really frustrating rules, but to partner with them to say, "Okay, great. I also want to have high quality research. How can we do this together?" Because they're there to help.

Kelly Malcom:

No, this has been such a great conversation on so many levels. Your work is fascinating, and just learning more about MICHR's support systems and everything that the CTSA is doing has just been really great to learn about. Thank you so much for appearing on the show.

Jordan Goebig:

Yeah, thank you so much. I came here in September. I only moved here a couple months ago. I actually just didn't generally know a lot about MICHR, so this has been really enlightening for me, even though I'm not a researcher, and I know Kelly touches their lives a bit more with her writing than I do, but as I get more involved with science Twitter, I've been spending more time talking to researchers. So I'm glad to have this resource that I can now plug and feel like I know what I'm talking about. So thank you so much for coming here this morning.

Dr. Julie Lumeng:

Thank you so much for having me. This was really fun.

Kelly Malcom:

Thanks for listening. The Fundamentals is part of the Michigan Medicine Podcast Network and produced by the Michigan Medicine Department of Communication in partnership with the University of Michigan Medical School. Find us and subscribe wherever you get your podcasts.