From the Heart
With personal conviction and professional determination, Tufts School of Medicine student Latrice Goosby Landry is taking on the epidemic of heart disease among African-Americans.
In elementary school, Latrice Goosby Landry thought pills were a normal part of a grown-up dinner, like the butter her parents put on cornbread.
"Everyone in my family had some sort of low-level chronic illness – mainly high blood pressure—that they were treating with medication," she recalls. "They accepted it as inevitable. So I did, too. I just figured that one day I'd probably have the same thing."
As she grew older, and started thinking about medicine as a possible career, Landry noticed differences between hers and other families. Her white friends usually had all four grandparents living, whereas Landry only had two. Distant relatives had died at relatively young ages. Her mother, aunts and sister had all suffered through at least one miscarriage. Births were always premature, often dangerously so. It seemed wrong.
In fact, Landry's experience was far from atypical. An estimated 40 percent of African-Americans suffer from hypertension, a condition that can lead to more severe health problems, especially if untreated. Consequently, African-Americans suffer heart attacks, strokes, kidney failure, vision problems, poor birth outcomes and premature death in far higher numbers than any other ethnic group. According to the Centers for Disease Control, African-Americans have a 30 percent greater chance of dying from heart disease -- already the nation's leading cause of death -- than their white counterparts. But until very recently, few clinical studies have attempted to probe the reasons behind the staggering disparity.Multimedia slideshow:
Landry intends to help change all that. At 27, with a nearly complete Ph.D. in nutritional epidemiology, the first year of medical school under her belt, and thesis research conducted under the auspices of a groundbreaking study, she is helping medicine edge closer to answering a critical question: why are so many African-Americans more likely than whites to develop cardiovascular problems and other health issues stemming from hypertension?
For the last four years, her thesis has required her to shuttle back and forth from the laboratory in Boston's bustling Chinatown to a converted strip-mall in Jackson, Mississippi, where she has joined the largest-ever single-site investigation of heart disease in African Americans. Poised, organized and direct, but with a sunny laugh and a sharp memory for names and faces, Landry has been eagerly welcomed into the fold by her peers.
Since 2000, the Jackson Heart Study has established a respectable cohort of 5,302 African-American residents from three nearby counties where heart disease is rampant. A staff of prominent clinicians, researchers and students—including Landry—have spent several years gathering and analyzing genetic, nutritional and general lifestyle data from these participants, in an attempt to identify the many risk factors for this particular population.
Landry's specific research examines the interactions between genes and nutrients and a variety of fatty acids, from "good" mono-unsaturated fats like the kind found in olive oil to "bad" trans-fats, such as margarine and Crisco—now banned from many restaurant menus.
"We've found that depending on what genetic inheritance you have, fatty acids have a different impact on your health," Landry explains. "So, you might be more likely to get cardiovascular disease if you have some genes rather than others. Some drugs might work on you, and some may not."
Once the study is further along, there is a possibility that her results may be used to build a nutrition intervention, a strategic plan aimed at a particular group to reduce that group's harmful eating habits. While such a plan might begin with Jackson, Mississippi, where heart disease is at all-time epidemic levels, Landry hopes the study will eventually reveal how any African American might be able to prevent the onset of heart disease by following a particular diet.
From 'Food Police' to Nutrition Scholar
Though she says she didn't necessarily make a connection between her family's health problems and what they ate, as a child Landry had already begun to take an interest in health guidelines, such as the USDA's food pyramid. Throughout her adolescence, she used it to supervise family meal times, banishing cake and cookies from the dinner table. Her mother and father coined a half-joking nickname for her: the Food Police. Nevertheless, they followed her advice.
In her senior year as a pre-med undergraduate at Tufts, Landry enrolled in a class at Tufts' Friedman School of Nutrition Science and Policy in primary care, designed for nutrition students who handle international crisis work in refugee camps and require basic clinical knowledge to deal with famine, HIV and other issues. The class hooked her on the concept of using nutrition to prevent medical problems, and in 2002 she enrolled in the Food Policy and Applied Nutrition master's program at Friedman, with a specialization in both international and domestic nutritional intervention.
She began to reflect. Until she warned them against it, her parents had indulged in a mostly Southern diet, generous in fat and salt. Her sister had developed hypertension in her 20s, an unusually young age. There certainly seemed to be a genetic factor. But Landry, who was careful to avoid foods she knew were bad for her, had not, at least so far. Was it possible food was the smoking gun?
"Specifically, I was interested in why my family had a history of so much hypertension, and what might have caused all their health problems, including my family's history of pre-term births. I knew I had to become a doctor to understand the medicine, but I also wanted to continue with research," says Landry. (continued)
Story and audio slideshows by Claire Vail, Web Communications Manager, School of Medicine. Photos by Melody Ko, University Photography.
This story originally ran on Sept. 15, 2008.