From Kitchen to Clinic: The Road to Recognition for Clinical Nutrition Departments

With centuries of medical development, people have gradually come to realize that there are only four causes for the occurrence of diseases:External environment, nutrition, immunity, genetics.Among these, external environment, immunity, and genetics have received considerable attention, even giving rise to many independent disciplines. Nutrition, however, has gradually been marginalized, often mistakenly regarded as merely concerning eating, drinking, and excretion."Elderly Care Department". With the arrival of the post-pandemic era, people have gradually come to recognize the importance of enhancing immunity, and nutrition is the most effective approach.

Director Deng Yuhong of the Second Affiliated Hospital of Guangzhou Medical University (hereinafter referred to as GMU2H)She was among the first group of experts in foods for special medical purposes (FSMP) in China, bearing witness to the rise and development of clinical nutrition in the country. A decade ago, upon assuming the role of Director of the Department of Clinical Nutrition, she resolved to transform it into a frontline clinical department.

In 2011, to enhance the comprehensive capabilities of hospitals and to develop clinical nutrition departments across China, the National Health Commission specifically added a new criterion to the accreditation standards for tertiary hospitals—Medical technology departments must be equipped with a nutrition department and corresponding clinical functional examination rooms.Following the introduction of the policy, hospitals have been establishing nutrition departments in succession.

According to the regulations in effect at that time, the director of each clinical department must be a person withAssociate Chief PhysicianThis position was to be held by a physician with the aforementioned professional title. Consequently, Deng Yuhong, who had originally been working in the Department of Neurology and had acquired some nutritional knowledge through prior exposure to the “ketogenic diet,” accepted an emergency appointment and assumed the role of Director of the Clinical Nutrition Department at the Second Affiliated Hospital of Guangzhou Medical University.

Appointing a neurologist as the director of the Department of Nutrition is, at its core,Shortage of Nutritional Department Personnel in China.

Although several prestigious medical schools in China, such as Zhejiang Medical University, Bethune Medical University, Sun Yat-sen University of Medical Sciences, and Shanghai Second Medical University, established clinical nutrition majors starting in the 1980s, the development of clinical nutrition disciplines across medical institutions nationwide has remained uneven. Consequently, advanced experiences in discipline construction have failed to effectively provide nationwide leadership and drive, resulting in a persistent scarcity of nutritional science professionals in China.

On the other hand, at that time, many hospitals in China had insufficient understanding of the Department of Clinical Nutrition and failed to recognize the importance of its development. Consequently, hospital investment in this department was extremely limited. In some cases, nutrition professionals who had completed five years of medical school training were assigned to manage hospital cafeterias upon joining hospitals. Such an employment environment significantly undermined the confidence of nutrition professionals and dampened the enthusiasm of prospective medical students to pursue careers in clinical nutrition. Over time,Many departments have discontinued admissions for the clinical nutrition major, further reducing the number of nutrition professionals in China.

“Once the hospital achieves Grade III status, I’ll return to my original department.” This was Deng Yuhong’s initial thought when she first joined the Department of Clinical Nutrition. However, as she became more deeply involved in the work of the department, she gradually realized thatThe relationship between nutrition and clinical practice is inseparable.

It is often said that “illness enters via the mouth,” but in fact, “healing” can also come through what we eat—nutrition plays a crucial role. Conditions such as hypertension and diabetes can not only be prevented through dietary attention but also managed through therapeutic nutrition. Deng Yuhong believes thatThe Department of Nutrition must never become a "nominal" department established solely for accreditation purposes; it holds significant potential in clinical treatment.

But how should this department, which is overlooked by most people, be developed? The issues involved are complex, but enhancing core technical capabilities is undoubtedly a key driving force.

To enable the Department of Clinical Nutrition to better serve patients, Deng Yuhong began focusing on product development. She surveyed clinical nutrition departments at hospitals across various regions and discovered that many were designing formulations for specialized dietary foods and foods for special medical purposes (FSMP). Despite lacking prior research experience in clinical nutrition, she decided to proceed through gradual exploration, initiating her research from this entry point.

After a period of exploration, Deng Yuhong developed several formulations for foods for special dietary uses. Like many such products, her offerings faced challenges including the inability to secure patents and complex regulatory approval processes.

The product has finally entered clinical trials, yet patients are not buying it.When providing nutritional interventions for patients, some even perceive it as a means for the hospital to “rake in money.”

“Doctor, I see that the ingredient list is no different from what I usually eat, and it doesn’t even taste as good as my home-cooked meals. Why does the price double just because you’ve processed it?” This was the most frequently asked question by patients at the time.

In retrospect, Deng Yuhong reflected on the incident. It is understandable for patients to hold such views given their lack of professional nutritional knowledge. However, this also exposes the shortcomings in the development of the Department of Clinical Nutrition:Currently, the specially formulated foods under development lack functional ingredients; patients perceive no tangible benefits, leading them to view nutritional products as expensive and ineffective. If this trend persists, the development of clinical nutrition departments will undoubtedly face significant challenges.

To help patients better understand the Department of Clinical Nutrition, it is essential to demonstrate tangible outcomes and achieve breakthroughs in core technologies. Deng Yuhong decided not to limit the department’s research focus solely to the proportional balance of the seven major nutrients (proteins, lipids, carbohydrates, minerals, dietary fiber, vitamins, and water). Instead, she aimed to integrate nutrition therapy with clinical practice, thereby delivering measurable “therapeutic efficacy” akin to other medical specialties.

To stay abreast of the latest developments in nutritional science, Deng Yuhong frequently attends international conferences. At the 2018 International Ketogenic Diet Nutrition Conference, she observed that the research focus of nutritionists from various countries had surprisingly shifted in a consistent direction towardResearch on Gut Microbiota。

This shift stems from the research team led by Professor Peter J. Turnbaugh of the Department of Microbiology and Immunology at the University of California, San Francisco, in《Cell》A published paper. The paper emphasizes:The efficacy of the ketogenic diet depends on the gut microbiota.

This realization struck Deng Yuhong: without breaking the old, the new cannot be established. The innovative development of a hospital’s clinical nutrition department must not be confined to superficial forms; only by breaking with the status quo can new possibilities in nutritional therapy be discovered. Thus, Deng Yuhong decided to build upon her initial research into food formulations by incorporating gut microbiota, integrating clinical nutrition with gut microbiome science, and embarked onNutritional Gut Microecology TechnologyExploration.

The so-called nutritional gut microbiota technology refers to the process of"Dietary Patterns + Gut Microbiota"By employing this approach, patient constitution is improved through dietary adjustments on one hand, while gut microbiota is modulated via microbial interventions on the other, thereby enhancing disease-resistant immunity. This dual strategy, addressing both internal and external factors, achieves therapeutic efficacy.

Currently, this therapy has demonstrated excellent therapeutic efficacy and has gained clinical recognition. Deng Yuhong and colleagues have published in major medical specialty journalsRecent 11 Papers on Gut Microbiota Technology, which has garnered positive feedback within the industry, with many hospital nutrition departments seeking to learn this technique. Meanwhile, The Second Affiliated Hospital of Guangzhou Medical University was recognized by the Hospital Management Institute of the National Health Commission for its work on “Nutritional Gut Microecology Technology.”The only demonstration unit in China specializing in “Exploration of Core Technologies in Clinical Nutrition”, calling on nutrition departments across China to learn from them.

Furthermore, from the hospital’s perspective,“Nutritional Gut Microbiome Technology” has broken through the traditional boundaries of the Department of Nutrition as a medical support unit, significantly expanding its scope of practice.Currently, in addition to traditional nutritional interventions, the Department of Clinical Nutrition at the Second Affiliated Hospital of Guangzhou Medical University provides medical services for patients with developmental abnormalities, malignant tumors, diabetes and gout, neurological disorders, autoimmune diseases, and digestive system diseases. With increasing patient willingness to seek consultation, the department has gained broader opportunities for development within the hospital, offering effective nutritional solutions for many complex and refractory conditions and bringing hope for improved health to patients.

Certainly, the development of nutritional gut microbiome technology also relies on the support of nutritional food and gut microbiome manufacturing enterprises. Doctors are like soldiers who can only be “invincible” when armed with weapons, while nutritional companies are the ones who produce these “weapons.” Only through collaboration between medical professionals and enterprises can more possibilities for patient recovery be brought about.

In an interview with VCBeat, Deng Yuhong stated, “We are highly confident in nutritional gut microbiome technology. Based on current clinical manifestations, this approach, which integrates dietary patterns with gut microbiome modulation, is poised to become a core technology in clinical nutrition due to its well-defined efficacy and safety profile.”In the future, it will undoubtedly help the Department of Nutrition become a true first-line treatment!”